Radiotherapy and chemotherapy are associated with improved outcomes over surgery and chemotherapy in the management of limited-stage small cell esophageal carcinoma

Abstract Background This retrospective study evaluates the efficacy and safety of surgery and chemotherapy (S + CT) vs. radiotherapy and CT (RT + CT) in patients with limited stage small cell esophageal cancer (LS-SCEC). Patients and methods Patients included in analysis (from our hospital and the l...

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Published in:Radiotherapy and oncology 2013-03, Vol.106 (3), p.317-322
Main Authors: Meng, Mao-Bin, Zaorsky, Nicholas G, Jiang, Chao, Tian, Li-Jun, Wang, Huan-Huan, Liu, Chun-Lei, Wang, Juan, Tao, Zhen, Sun, Yao, Wang, Jun, Pang, Qing-Song, Zhao, Lu-Jun, Yuan, Zhi-Yong, Ping, Wang
Format: Article
Language:English
Subjects:
Adult
Aged
Carcinoma, Small Cell - mortality
Carcinoma, Small Cell - pathology
Carcinoma, Small Cell - therapy
Chemoradiotherapy
Chemotherapy
Esophageal Neoplasms - mortality
Esophageal Neoplasms - pathology
Esophageal Neoplasms - therapy
Female
Hematology, Oncology and Palliative Medicine
Humans
Male
Middle Aged
Neoplasm Staging
Proportional Hazards Models
Radiotherapy
Retrospective Studies
Small cell esophageal carcinoma
Surgery
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Summary:Abstract Background This retrospective study evaluates the efficacy and safety of surgery and chemotherapy (S + CT) vs. radiotherapy and CT (RT + CT) in patients with limited stage small cell esophageal cancer (LS-SCEC). Patients and methods Patients included in analysis (from our hospital and the literature) were treated with S + CT or RT + CT between 1989 and 2012. The primary end point was overall survival (OS); secondary end points included tumor response and toxicity. Kaplan–Meier OS curves were compared with the log-rank test. Cox regression analysis was used to determine prognosticators for OS. Results A total of 127 patients were included: 14 from our hospital and 113 from the literature. Fifty-four (43%) and 73 (57%) patients received S + CT or RT + CT, respectively. The median OS of all patients was 21.0 months. OS was longer for those who received RT + CT rather than S + CT (33.0 vs. 17.5 months, p = 0.02), especially those with N1 disease. Uni- and multi-variate analyses showed tumor location (upper 1/3rd of esophagus) and type of treatment (S + CT) were poor prognostic factors of OS. Conclusion LS-SCEC patients treated with RT + CT had an improved OS compared to those treated with S + RT. Thus, RT + CT should be considered as a primary approach for these patients.
ISSN:0167-8140
1879-0887
DOI:10.1016/j.radonc.2013.01.008