Experience in Locally Advanced Esophageal Cancer with Definitive Chemoradiotherapy at the National Oncology Institute in the Period 2012-2022

Jimenez Hiciano Juan Jose; Pinto Llerena Jose; Perez Jimenez Gaspar

doi:doi:10.11648/j.crj.20231101.13

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Experience in Locally Advanced Esophageal Cancer with Definitive Chemoradiotherapy at the National Oncology Institute in the Period 2012-2022

Jimenez Hiciano Juan Jose, Pinto Llerena Jose, Perez Jimenez Gaspar

Published in Cancer Research Journal (Volume 11, Issue 1)

Received: 29 December 2022 Accepted: 25 January 2023 Published: 14 February 2023

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Abstract

Introduction: The World Health Organization (WHO) estimates 18 million people were diagnosed with cancers in 2020, of these 600,000 were esophageal cancer and ranks 6th in mortality. In Panama, in 2020, 58 new cases were diagnosed, with a lethality of 90%. Despite advances in the therapeutic approach and survival of localized esophageal cancer, we are unaware of the survival results associated with concomitant chemoradiotherapy treatment. Methodology: We conducted a retrospective study, reviewing the electronic medical records of patients with locally advanced esophageal cancer treated with Chemotherapy-Radiotherapy at the National Institute of Oncology from 2012 to 2022. Results were evaluated using the Kaplan Meier method, long rank test and a multivariate analysis with Cox regression. Objective: to evaluate the survival results in patient with locally advanced esophageal cancer treated with chemotherapy-radiotherapy. Results: 94 patients were evaluated, with a mean age of 64 years. The median time to progression (TPP) was 6 months and the median overall survival (OS) was 9 months. 69% patient has Eastern Cooperative Oncology Group (ECOG) 1, with a predominance of squamous histology in 89% and the degree of differentiation moderately differentiated in 55.3%. The main chemotherapy treatment was based on a scheme of weekly Carboplatin plus Paclitaxel in 41.5%, of which 66% received a dose of radiotherapy ≥45 Gy, with a 5-week extension time. A post-treatment radiographic response was evidenced with a clinical benefit of 36.2% and an objective response of 27.7%. The main adverse effects were dysphagia (16%), neutropenia (8.3%), nausea and vomiting (7.4%), and weight loss (7.4%). When analyzing the associated factors in relation to OS, in the multivariate analysis, the ECOG and the well-differentiated histological grade turned out to be significant association factors for better OS; but for the TTP, there were no associated factors identified when performing multivariate analysis. Conclusions: In this retrospective analysis, we found a median TTP of 6 months and a median OS of 9 months, which is below the values in the literature. The ECOG and the degree of differentiation were the factors associated with a better overall survival. Hematological and gastrointestinal adverse events were the most reported. It is important to choose patients in the best clinical condition for concomitant treatment with CT/RT to achieve better clinical results.

Published in	Cancer Research Journal (Volume 11, Issue 1)
DOI	10.11648/j.crj.20231101.13
Page(s)	24-27
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Esophageal Cancer, Chemoradiotherapy, Overall Survival, Time to Progression

References

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[3]	Rustgi A, El-Serag H. Esophageal Carcinoma. New England Journal of Medicine [Internet]. 2014 [cited 17 May 2021]; 371 (26): 2499-2509. Available from: http://10.1056/NEJMra1314530
[4]	Yip H, Chiu P. Endoscopic diagnosis and management of early squamous cell carcinoma of esophagus. journal of Thoracic Disease [Internet]. 2017 [cited 2021 May 17]; 9 (S8): S 689-S696. Available from: http://10.21037/jtd.2017.06.57
[5]	Veerendra Kumar K, Sagar R, Mathew J. Squamous Cell Carcinoma: Esophagus. Squamous Cell Carcinoma - Hallmark and Treatment Modalities [Internet]. 2020 [cited 2021 May 17];. Available from: http://10.5772/intechopen.86196
[6]	Arantes V, Espinoza-Ríos J. Early esophageal squamous cell carcinoma management through endoscopic submucosal dissection. Gastroenterology Journal of Mexico (English Edition) [Internet]. 2018 [cited 2021 May 17]; 83 (3): 259-267. Available from: http://10.1016/j.rgmxen.2018.05.004
[7]	Ohashi S, Miyamoto S, Kikuchi O, Goto T, Amanuma Y, Muto M. Recent Advances From Basic and Clinical Studies of esophageal Squamous Cell Carcinoma. Gastroenterology [Internet]. 2015 [cited 18 April 2021]; 149 (7): 1700-1715. Available from: http://10.1053/j.gastro.2015.08.054
[8]	Cooper JS, Guo MD, Herskovic A, Macdonald JS, Chemoradiotherapy of locally advanced esophageal cancer: long-term follow -up of a prospective randomized trial (RTOG 85-01). radiation Therapy Oncology Group. NEVER. 1999 May 5; 281 (17): 1623-7. doi: 10.1001/jama.281.17.1623.
[9]	Minsky BD, Pajak TF, Ginsberg RJ, Pisansky TM, Martenson J. INT 0123 (Radiation Therapy Oncology Group 94-05) phase III trial of combined-modality therapy for esophageal cancer: high-dose versus standard - dose radiation therapy. J Clin Oncol. 2002 Mar 1; 20 (5): 1167-74. doi: 10.1200/JCO.2002.20.5.1167.
[10]	Li LQ, Fu QG, Zhao WD, Wang YD, Meng WW, Su TS. Chemoradiotherapy Versus Chemotherapy Alone for Advanced Esophageal Squamous Cell Carcinoma: The Role of Definitive Radiotherapy for Primary Tumor in the Metastatic Setting. Front Oncol. 2022 Mar 30; 12: 824206.
[11]	Herskovic A, Martz K, Al - Sarraf M. Combined Chemotherapy and Radiotherapy Compared with Radiotherapy Alone in Patients with Cancer of the Esophagus. New England Journal of Medicine. 1992; 326 (24): 1593-1598.
[12]	Hashimoto, Masashi, et al. “Induction Chemoradiotherapy Including Docetaxel, Cisplatin, and 5-Fluorouracil for Locally Advanced Esophageal Cancer.” Esophagus, 2 Jan. 2020, link.springer.com/article/10.1007%2Fs10388-019-00709-5, 10.1007/s10388-019-00709-5. Accessed 29 Jan. 2020.
[13]	Defoe SG, Pennathur A, Flickinger JC, Heron DE, Gibson MK, Luketich JD, Greenberger JS. Retrospective review of patients with locally advanced esophageal cancer treated at the University of Pittsburgh. Am J Clin Oncol. 2011 Dec; 34 (6): 587-92. doi: 10.1097/COC.0b013e3181f942af.
[14]	Sugimura, Keijiro, et al. “Multicenter Randomized Phase 2 Trial Comparing Chemoradiotherapy and Docetaxel plus 5-Fluorouracil and Cisplatin Chemotherapy as Initial Induction Therapy for Subsequent Conversion Surgery in Patients with Clinical T4b Esophageal Cancer: Short-Term Results.” Annals of Surgery, vol. 274, no. 6, 1 Dec. 2021, p. e465, journals.lww.com/annalsofsurgery/Abstract/2021/12000/Multicenter_Randomized_Phase_2_Trial_Comparing.34.aspx, 10.1097/SLA.0000000000004564. Accessed 21 Jan. 2023.
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Jimenez Hiciano Juan Jose, Pinto Llerena Jose, Perez Jimenez Gaspar. (2023). Experience in Locally Advanced Esophageal Cancer with Definitive Chemoradiotherapy at the National Oncology Institute in the Period 2012-2022. Cancer Research Journal, 11(1), 24-27. https://doi.org/10.11648/j.crj.20231101.13

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ACS Style

Jimenez Hiciano Juan Jose; Pinto Llerena Jose; Perez Jimenez Gaspar. Experience in Locally Advanced Esophageal Cancer with Definitive Chemoradiotherapy at the National Oncology Institute in the Period 2012-2022. Cancer Res. J. 2023, 11(1), 24-27. doi: 10.11648/j.crj.20231101.13

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AMA Style

Jimenez Hiciano Juan Jose, Pinto Llerena Jose, Perez Jimenez Gaspar. Experience in Locally Advanced Esophageal Cancer with Definitive Chemoradiotherapy at the National Oncology Institute in the Period 2012-2022. Cancer Res J. 2023;11(1):24-27. doi: 10.11648/j.crj.20231101.13

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@article{10.11648/j.crj.20231101.13,
  author = {Jimenez Hiciano Juan Jose and Pinto Llerena Jose and Perez Jimenez Gaspar},
  title = {Experience in Locally Advanced Esophageal Cancer with Definitive Chemoradiotherapy at the National Oncology Institute in the Period 2012-2022},
  journal = {Cancer Research Journal},
  volume = {11},
  number = {1},
  pages = {24-27},
  doi = {10.11648/j.crj.20231101.13},
  url = {https://doi.org/10.11648/j.crj.20231101.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.crj.20231101.13},
  abstract = {Introduction: The World Health Organization (WHO) estimates 18 million people were diagnosed with cancers in 2020, of these 600,000 were esophageal cancer and ranks 6th in mortality. In Panama, in 2020, 58 new cases were diagnosed, with a lethality of 90%. Despite advances in the therapeutic approach and survival of localized esophageal cancer, we are unaware of the survival results associated with concomitant chemoradiotherapy treatment. Methodology: We conducted a retrospective study, reviewing the electronic medical records of patients with locally advanced esophageal cancer treated with Chemotherapy-Radiotherapy at the National Institute of Oncology from 2012 to 2022. Results were evaluated using the Kaplan Meier method, long rank test and a multivariate analysis with Cox regression. Objective: to evaluate the survival results in patient with locally advanced esophageal cancer treated with chemotherapy-radiotherapy. Results: 94 patients were evaluated, with a mean age of 64 years. The median time to progression (TPP) was 6 months and the median overall survival (OS) was 9 months. 69% patient has Eastern Cooperative Oncology Group (ECOG) 1, with a predominance of squamous histology in 89% and the degree of differentiation moderately differentiated in 55.3%. The main chemotherapy treatment was based on a scheme of weekly Carboplatin plus Paclitaxel in 41.5%, of which 66% received a dose of radiotherapy ≥45 Gy, with a 5-week extension time. A post-treatment radiographic response was evidenced with a clinical benefit of 36.2% and an objective response of 27.7%. The main adverse effects were dysphagia (16%), neutropenia (8.3%), nausea and vomiting (7.4%), and weight loss (7.4%). When analyzing the associated factors in relation to OS, in the multivariate analysis, the ECOG and the well-differentiated histological grade turned out to be significant association factors for better OS; but for the TTP, there were no associated factors identified when performing multivariate analysis. Conclusions: In this retrospective analysis, we found a median TTP of 6 months and a median OS of 9 months, which is below the values in the literature. The ECOG and the degree of differentiation were the factors associated with a better overall survival. Hematological and gastrointestinal adverse events were the most reported. It is important to choose patients in the best clinical condition for concomitant treatment with CT/RT to achieve better clinical results.},
 year = {2023}
}

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TY - JOUR
T1 - Experience in Locally Advanced Esophageal Cancer with Definitive Chemoradiotherapy at the National Oncology Institute in the Period 2012-2022
AU - Jimenez Hiciano Juan Jose
AU - Pinto Llerena Jose
AU - Perez Jimenez Gaspar
Y1 - 2023/02/14
PY - 2023
N1 - https://doi.org/10.11648/j.crj.20231101.13
DO - 10.11648/j.crj.20231101.13
T2 - Cancer Research Journal
JF - Cancer Research Journal
JO - Cancer Research Journal
SP - 24
EP - 27
PB - Science Publishing Group
SN - 2330-8214
UR - https://doi.org/10.11648/j.crj.20231101.13
AB - Introduction: The World Health Organization (WHO) estimates 18 million people were diagnosed with cancers in 2020, of these 600,000 were esophageal cancer and ranks 6th in mortality. In Panama, in 2020, 58 new cases were diagnosed, with a lethality of 90%. Despite advances in the therapeutic approach and survival of localized esophageal cancer, we are unaware of the survival results associated with concomitant chemoradiotherapy treatment. Methodology: We conducted a retrospective study, reviewing the electronic medical records of patients with locally advanced esophageal cancer treated with Chemotherapy-Radiotherapy at the National Institute of Oncology from 2012 to 2022. Results were evaluated using the Kaplan Meier method, long rank test and a multivariate analysis with Cox regression. Objective: to evaluate the survival results in patient with locally advanced esophageal cancer treated with chemotherapy-radiotherapy. Results: 94 patients were evaluated, with a mean age of 64 years. The median time to progression (TPP) was 6 months and the median overall survival (OS) was 9 months. 69% patient has Eastern Cooperative Oncology Group (ECOG) 1, with a predominance of squamous histology in 89% and the degree of differentiation moderately differentiated in 55.3%. The main chemotherapy treatment was based on a scheme of weekly Carboplatin plus Paclitaxel in 41.5%, of which 66% received a dose of radiotherapy ≥45 Gy, with a 5-week extension time. A post-treatment radiographic response was evidenced with a clinical benefit of 36.2% and an objective response of 27.7%. The main adverse effects were dysphagia (16%), neutropenia (8.3%), nausea and vomiting (7.4%), and weight loss (7.4%). When analyzing the associated factors in relation to OS, in the multivariate analysis, the ECOG and the well-differentiated histological grade turned out to be significant association factors for better OS; but for the TTP, there were no associated factors identified when performing multivariate analysis. Conclusions: In this retrospective analysis, we found a median TTP of 6 months and a median OS of 9 months, which is below the values in the literature. The ECOG and the degree of differentiation were the factors associated with a better overall survival. Hematological and gastrointestinal adverse events were the most reported. It is important to choose patients in the best clinical condition for concomitant treatment with CT/RT to achieve better clinical results.
VL - 11
IS - 1
ER -

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Author Information

Jimenez Hiciano Juan Jose

Gastric Tumor Unit, Teaching and Research Medical Oncology Service, National Oncological Institute of Panama, Panama City, Panama
Pinto Llerena Jose

Gastric Tumor Unit, Teaching and Research Medical Oncology Service, National Oncological Institute of Panama, Panama City, Panama
Perez Jimenez Gaspar

Gastric Tumor Unit, Teaching and Research Medical Oncology Service, National Oncological Institute of Panama, Panama City, Panama

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APA Style

Jimenez Hiciano Juan Jose, Pinto Llerena Jose, Perez Jimenez Gaspar. (2023). Experience in Locally Advanced Esophageal Cancer with Definitive Chemoradiotherapy at the National Oncology Institute in the Period 2012-2022. Cancer Research Journal, 11(1), 24-27. https://doi.org/10.11648/j.crj.20231101.13

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ACS Style

Jimenez Hiciano Juan Jose; Pinto Llerena Jose; Perez Jimenez Gaspar. Experience in Locally Advanced Esophageal Cancer with Definitive Chemoradiotherapy at the National Oncology Institute in the Period 2012-2022. Cancer Res. J. 2023, 11(1), 24-27. doi: 10.11648/j.crj.20231101.13

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AMA Style

Jimenez Hiciano Juan Jose, Pinto Llerena Jose, Perez Jimenez Gaspar. Experience in Locally Advanced Esophageal Cancer with Definitive Chemoradiotherapy at the National Oncology Institute in the Period 2012-2022. Cancer Res J. 2023;11(1):24-27. doi: 10.11648/j.crj.20231101.13

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@article{10.11648/j.crj.20231101.13,
  author = {Jimenez Hiciano Juan Jose and Pinto Llerena Jose and Perez Jimenez Gaspar},
  title = {Experience in Locally Advanced Esophageal Cancer with Definitive Chemoradiotherapy at the National Oncology Institute in the Period 2012-2022},
  journal = {Cancer Research Journal},
  volume = {11},
  number = {1},
  pages = {24-27},
  doi = {10.11648/j.crj.20231101.13},
  url = {https://doi.org/10.11648/j.crj.20231101.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.crj.20231101.13},
  abstract = {Introduction: The World Health Organization (WHO) estimates 18 million people were diagnosed with cancers in 2020, of these 600,000 were esophageal cancer and ranks 6th in mortality. In Panama, in 2020, 58 new cases were diagnosed, with a lethality of 90%. Despite advances in the therapeutic approach and survival of localized esophageal cancer, we are unaware of the survival results associated with concomitant chemoradiotherapy treatment. Methodology: We conducted a retrospective study, reviewing the electronic medical records of patients with locally advanced esophageal cancer treated with Chemotherapy-Radiotherapy at the National Institute of Oncology from 2012 to 2022. Results were evaluated using the Kaplan Meier method, long rank test and a multivariate analysis with Cox regression. Objective: to evaluate the survival results in patient with locally advanced esophageal cancer treated with chemotherapy-radiotherapy. Results: 94 patients were evaluated, with a mean age of 64 years. The median time to progression (TPP) was 6 months and the median overall survival (OS) was 9 months. 69% patient has Eastern Cooperative Oncology Group (ECOG) 1, with a predominance of squamous histology in 89% and the degree of differentiation moderately differentiated in 55.3%. The main chemotherapy treatment was based on a scheme of weekly Carboplatin plus Paclitaxel in 41.5%, of which 66% received a dose of radiotherapy ≥45 Gy, with a 5-week extension time. A post-treatment radiographic response was evidenced with a clinical benefit of 36.2% and an objective response of 27.7%. The main adverse effects were dysphagia (16%), neutropenia (8.3%), nausea and vomiting (7.4%), and weight loss (7.4%). When analyzing the associated factors in relation to OS, in the multivariate analysis, the ECOG and the well-differentiated histological grade turned out to be significant association factors for better OS; but for the TTP, there were no associated factors identified when performing multivariate analysis. Conclusions: In this retrospective analysis, we found a median TTP of 6 months and a median OS of 9 months, which is below the values in the literature. The ECOG and the degree of differentiation were the factors associated with a better overall survival. Hematological and gastrointestinal adverse events were the most reported. It is important to choose patients in the best clinical condition for concomitant treatment with CT/RT to achieve better clinical results.},
 year = {2023}
}

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