Cervical esophageal cancer: chemoradiation as an alternative to surgery

  • Chen YH & al.
  • Cancers (Basel)
  • 30 Mar 2019

  • curated by Emily Willingham, PhD
  • Univadis Clinical Summaries
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Takeaway

  • For locally advanced cervical esophageal squamous cell carcinoma (ESCC), curative chemoradiotherapy (CCRT) appears “reasonable,” with salvage surgery considered for residual disease.

Why this matters

  • The gold standard for cervical ESCC has been radical esophagectomy, with the obvious potential for complications, comorbidity, and adverse effects on QoL.
  • CCRT shows promise of similar survival benefit to that of radical surgery.

Key results

  • Response to CCRT was similar between cervical and matched thoracic ESCC groups.
  • Cervical group had better OS, however: 21.4 vs 10.1 months (P=.012).
  • Patients in either group with complete response (CR) had better OS.
  • Cervical group had more CR: 33% vs 16% (P=.038).
  • Those in cervical group with CR had better OS vs those without CR: 42.9 vs 11.6 months (P<.001>
  • Number operated in the cervical group without CR (n=3) was small, with no OS differences from CR group.

Study design

  • 63 patients with cervical ESCC propensity matched for tumor features and age to 63 of 348 with thoracic ESCC.
  • Median dose 66 (range, 66-70) Gy for cervical, 50.4 (range, 50-50.4) Gy for thoracic.
  • OS compared.
  • Funding: National Science Council of Taiwan; Chang Gung Memorial Hospital.

Limitations

  • Retrospective design, single center, small number of patients.

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