Cancer Research and Treatment

Original Articles

Intensity-Modulated Radiotherapy versus Three-Dimensional Conformal Radiotherapy in Definitive Chemoradiotherapy for Cervical Esophageal Squamous Cell Carcinoma: Comparison of Survival Outcomes and Toxicities: Nai-Bin Chen, Bo Qiu, Jun Zhang, Meng-Yun Qiang, Yu-Jia Zhu, Bin Wang, Jin-Yu Guo, Ling-Zhi Cai, Shao-Min Huang, Meng-Zhong Liu, Qun Li, Yong-Hong Hu, Qi-Wen Li, Hui Liu; Cancer Res Treat. 2020;52(1):31-40. Published online April 30, 2019; DOI: https://doi.org/10.4143/crt.2018.624

Purpose
The purpose of this study was to compare the survival and toxicities in cervical esophageal squamous cell carcinoma (CESCC) treated by concurrent chemoradiothrapy with either three-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) techniques.
Materials and Methods
A total of 112 consecutive CESCC patients were retrospectively reviewed. 3D-CRT and IMRT groups had been analyzed by propensity score matching method, with sex, age, Karnofsky performance status, induction chemotherapy, and tumor stage well matched. The Kaplan-Meier method and Cox proportional hazards model were used for overall survival (OS) and progression-free survival (PFS). Toxicities were compared between two groups by Fisher exact test.
Results
With a median follow-up time of 34.9 months, the 3-year OS (p=0.927) and PFS (p=0.859) rate was 49.6% and 45.8% in 3D-CRT group, compared with 54.4% and 42.8% in IMRT group. The rates of grade ≥ 3 esophagitis, grade ≥ 2 pneumonitis, esophageal stricture, and hemorrhage were comparable between two groups, while the rate of tracheostomy dependence was much higher in IMRT group than 3D-CRT group (14.3% vs.1.8%, p=0.032). Radiotherapy technique (hazard ratio [HR], 0.09; 95% confidence interval [CI], 0.01 to 0.79) and pretreatment hoarseness (HR, 0.12; 95% CI 0.02 to 0.70) were independently prognostic of tracheostomy dependence.
Conclusion
No survival benefits had been observed while comparing IMRT versus 3D-CRT in CESCC patients. IMRT with fraction dose escalation and pretreatment hoarseness were considered to be associated with a higher risk for tracheostomy dependence. Radiation dose escalation beyond 60 Gy should be taken into account carefully when using IMRT with hypofractionated regimen.

Citations

Citations to this article as recorded by

Current and future on definitive concurrent chemoradiotherapy for inoperable locally advanced esophageal squamous cell carcinoma
Renxian Xie, Qingxin Cai, Tong Chen, Hongxin Huang, Chuangzhen Chen
Frontiers in Oncology.2024;[Epub] CrossRef
Tumor-Derived Exosomal miR-143-3p Induces Macrophage M2 Polarization to Cause Radiation Resistance in Locally Advanced Esophageal Squamous Cell Carcinoma
Lin-Rui Gao, Jiajun Zhang, Ning Huang, Wei Deng, Wenjie Ni, Zefen Xiao, Mei Liu
International Journal of Molecular Sciences.2024; 25(11): 6082. CrossRef
Dose escalation in radical radio(chemo)therapy for cervical and upper thoracic esophageal cancer with 3DCRT/IMRT (ChC&UES): a multicenter retrospective study
Xiao-Han Zhao, Wen-Cheng Zhang, Xin Wang, Jun-Qiang Chen, Yuan-Ji Xu, Kuai-Le Zhao, Wei Huang, Pu-Dong Qian, Ya-Tian Liu, Xiao-Lin Ge, Xiao-Jie Xia, Chen-Gang Weng, Chun-Yue Gai, He-Song Wang, Hong-Mei Gao, Wen-Bin Shen, Shu-Chai Zhu
Radiation Oncology.2024;[Epub] CrossRef
Oncological outcomes of squamous cell carcinoma of the cervical esophagus treated with definitive (chemo-)radiotherapy: a systematic review and meta-analysis
Armando De Virgilio, Andrea Costantino, Bianca Maria Festa, Giuseppe Mercante, Davide Franceschini, Ciro Franzese, Marta Scorsetti, Andrea Marrari, Raffaele Cavina, Salvatore Marano, Carlo Castoro, Giuseppe Spriano
Journal of Cancer Research and Clinical Oncology.2023; 149(3): 1029. CrossRef
Effect of preoperative radiotherapy on the prognosis of patients with stage cTxN0M0 esophageal squamous cell carcinoma: propensity score matching analysis based on SEER database
Zixian Jin, Jiajing Sun, Jian Zhang, Jianfei Shen, Bo Zhang
Frontiers in Surgery.2023;[Epub] CrossRef
Paclitaxel and cisplatin combined with concurrent involved-field irradiation in definitive chemoradiotherapy for locally advanced esophageal squamous cell carcinoma: a phase II clinical trial
Hui Li, Ying Fang, Dayong Gu, Mingyu Du, Zhi Zhang, Lei Sun, Guoren Zhou, Jinjun Ye
Radiation Oncology.2022;[Epub] CrossRef
A Retrospective Study of Chemotherapy and 3D-Image-Guided Afterloading Intracavitary Radiotherapy in Locally Advanced Cervical Cancer
Xiaojun Li, Cunlian An, Chunlan Feng, Jieren Sun, Huixiang Lu, Xiaodong Yang, Kaiping Wang, Ruimei Wang, Zhongjie Shi
Journal of Oncology.2022; 2022: 1. CrossRef
Intensity modulated radiotherapy might be effective for locally advanced esophageal carcinosarcoma: A single center’s experience and review of literature
Siran Yang, Wenqing Wang, Nan Bi, Zongmei Zhou, Qinfu Feng, Zefen Xiao, Dongfu Chen, Jun Liang, Jima Lu, Jianyang Wang, Xin Wang, Jingbo Wang, Yong Yang, Ningning Lu, Hongxing Zhang, Luhua Wang
Medicine.2022; 101(42): e31215. CrossRef
Outcome of chemoradiotherapy using intensity-modulated radiation therapy for cervical esophageal cancer: a single institute experience
Masahiro Inada, Yasumasa Nishimura, Kazuki Ishikawa, Takuya Uehara, Yutaro Wada, Yasuo Oguma, Hiroshi Doi, Kiyoshi Nakamatsu
Esophagus.2021; 18(3): 638. CrossRef
Radiation-induced acute injury of intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy in induction chemotherapy followed by concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: a prospective cohor
Zexin Yao, Bing Zhang, Jialin Huang, Lei Shi, Biao Cheng
Scientific Reports.2021;[Epub] CrossRef
Correlation between the γ passing rates of IMRT plans and the volumes of air cavities and bony structures in head and neck cancer
Zhengwen Shen, Xia Tan, Shi Li, Xiumei Tian, Huanli Luo, Ying Wang, Fu Jin
Radiation Oncology.2021;[Epub] CrossRef
Rehabilitation Nursing Intervention Can Improve Dysphagia and Quality of Life of Patients Undergoing Radiotherapy for Esophageal Cancer
Xiange Zeng, Ling Li, Wenjing Wang, Lihui Zhu, Alamgeer Yuchi
Journal of Oncology.2021; 2021: 1. CrossRef
Late Toxicities, Failure Patterns, Local Tumor Control, and Survival of Esophageal Squamous Cell Carcinoma Patients After Chemoradiotherapy With a Simultaneous Integrated Boost: A 5-Year Phase II Study
Chuangzhen Chen, Jianzhou Chen, Ting Luo, Siyan Wang, Hong Guo, Chengbing Zeng, Yanxuan Wu, Weitong Liu, Ruihong Huang, Tiantian Zhai, Zhijian Chen, Derui Li
Frontiers in Oncology.2021;[Epub] CrossRef
Conformal radiation therapy versus volumetric arc therapy in high dose concurrent chemoradiotherapy for carcinoma esophagus
Tapas Kumar Dora, Jayashree Deshmukh, Abhishek Chatterjee, Alok Goel, Subhadeep Bose, Avtar Singh, Amit Saini, Shefali Pahwa, Sarbani Ghosh Laskar, Jai Prakash Agarwal, Shyam Kishore Shrivastava, Rakesh Kapoor
Cancer Research, Statistics, and Treatment.2021; 4(3): 456. CrossRef
Propensity score-based comparison of survival and radiation pneumonitis after definitive chemoradiation for esophageal cancer: Intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy
Kaiqi Lan, Jinhan Zhu, Jun Zhang, Sha Zhou, Yadi Yang, Zizhen Feng, Li Zhang, Shi Wang, Mian Xi
Radiotherapy and Oncology.2020; 149: 228. CrossRef
LINC00473 contributes to the radioresistance of esophageal squamous cell carcinoma by regulating microRNA‑497‑5p and cell division cycle 25A
Wei‑Hua Liu, Han‑Yong Qiao, Jian Xu, Wei‑Qing Wang, Yi‑Lei Wu, Xia Wu
International Journal of Molecular Medicine.2020; 46(2): 571. CrossRef
A multicenter prospective phase III clinical randomized study of simultaneous integrated boost intensity-modulated radiotherapy with or without concurrent chemotherapy in patients with esophageal cancer: 3JECROG P-02 study protocol
Lin-rui Gao, Xin Wang, Weiming Han, Wei Deng, Chen Li, Xiaomin Wang, Yidian Zhao, Wenjie Ni, Xiao Chang, Zongmei Zhou, Lei Deng, Wenqing Wang, Wenyang Liu, Jun Liang, Tao Zhang, Nan Bi, Jianyang Wang, Yirui Zhai, Qinfu Feng, Jima Lv, Ling Li, Zefen Xiao
BMC Cancer.2020;[Epub] CrossRef

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Clinicopathologic Characteristics and Prognosis of Tongue Squamous Cell Carcinoma in Patients with and without a History of Radiation for Nasopharyngeal Carcinoma: A Matched Case-Control Study: Peng Zhang, Li Zhang, Hui Liu, Lei Zhao, Yong Li, Jing-Xian Shen, Qing Liu, Meng-Zhong Liu, Mian Xi; Cancer Res Treat. 2017;49(3):695-705. Published online October 11, 2016; DOI: https://doi.org/10.4143/crt.2016.317

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Purpose
Previous studies reported an association between an increased risk of tongue cancer and radiation treatment for nasopharyngeal carcinoma (NPC). This study compared the clinicopathologic characteristics and outcomes of tongue squamous cell carcinoma (TSCC) in patients with and without a history of radiotherapy for NPC.
Materials and Methods
From 1965 to 2009, a total of 73 patients were diagnosed with TSCC with a history of radiotherapy for NPC. The patients were matched in a 1:3 ratio with patients with sporadic TSCC according to age, sex, and year of the TSCC diagnosis. The primary endpoint was the overall survival.
Results
The median interval from NPC to TSCC was 82 months. The NPC survivors were more likely to be diagnosed with a more advanced T classification, less likely to have lymph node involvement, and more likely to have the tumor located in the dorsum of the tongue than sporadic TSCC. Regarding the histologic characteristics, the NPC survivors were more likely to have a weak lymphocytic host response, low tumor budding, and low risk of a worse pattern of invasion. The sporadic TSCC patients had a better overall survival (hazard ratio, 0.690; p=0.033) than the NPC survivors. In competing risks analysis, the cumulative incidence functions for the competing event (documented non-tongue cancer death) were significantly higher in the NPC survivors (Gray’s test, p=0.001).
Conclusion
TSCC patients with a history of radiotherapy for NPC appear to have particular clinicopathologic features, a poorer survival, and are more likely to die from non-tongue cancer causes than those with sporadic TSCC.

Citations

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