Stage I esophageal cancer treatable with chemoradiotherapy
MedWire News: Patients with stage I esophageal squamous cell carcinoma (SCC) who are treated with chemoradiotherapy (CRT) have similar overall and progression-free survival (PFS) rates to those who receive esophagectomy, Japanese researchers report.
CRT was associated with a higher rate of local recurrence than esophagectomy; however, Ryu Ishihara (Osaka Medical Center for Cancer and Cardiovascular Diseases) and colleagues found that this did not affect the overall survival rate associated with CRT as most recurrences were endoscopically treatable.
As reported in the American Journal of Gastroenterology, the researchers observed the 1- and 3-year survival rates among 169 stage I esophageal SCC patients treated with CRT (n=54) or conventional esophagectomy (n=115), and found similar overall survival and PFS rates among both groups.
Specifically, 97.4% and 85.5% of patients in the esophagectomy group were alive at 1 and 3 years after treatment end, respectively, as were a corresponding 98.1% and 88.7% of the CRT group.
Respective PFS rates at 1 and 3 years post-treatment were 93.9% and 81.9% in the surgical group, and 90.5% and 83.5% in the CRT group.
Even after adjustment for gender, age, and tumor size, the inter-group overall survival rates remained comparable, with respective 1- and 3-year rates of 93.9% and 81.9% in the esophagectomy group, and 84.6% and 70.1% in the CRT group. The same trend was seen for PFS rates.
Ishihara et al report that local recurrence of cancer was more common among CRT-treated than esophagectomy patients, however most post-CRT recurrences were intramucosal carcinomas that were curable via endoscopic resection.
"CRT seems to offer a viable alternative to esophagectomy for the treatment of patients with clinical stage I esophageal cancer," conclude the researchers.
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By Lauretta Ihonor