M1532 Preoperative Chemoradiation with Intensify-Modulated Radiation Therapy (IMRT) Increases Pathological Complete Response Rate in Locally Advanced Squamous Cell Carcinoma of the Esophagus

2008 ◽  
Vol 134 (4) ◽  
pp. A-867
Author(s):  
Chadin Tharavej ◽  
Patpong Navicharern
Keyword(s):  
Squamous Cell Carcinoma ◽  
Radiation Therapy ◽  
Response Rate ◽  
Pathological Complete Response ◽  
Complete Response Rate ◽  
Locally Advanced ◽  
Complete Response ◽  
Preoperative Chemoradiation ◽  
Advanced Squamous Cell Carcinoma ◽  
Carcinoma Of The Esophagus

Nimotuzumab in combination with preoperative concurrent chemoradiotherapy for locally advanced esophageal squamous cell carcinoma: A prospective trial.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 101-101
Author(s):  
Xiaoyuan Wu ◽  
Yongshun Chen ◽  
Yuanyuan Yang ◽  
Daxuan Hao ◽  
Xue Li ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Concurrent Chemoradiotherapy ◽  
Response Rate ◽  
Pathological Complete Response ◽  
Complete Response Rate ◽  
Locally Advanced ◽  
Complete Response ◽  
Clinical Response Rate

101 Background: Preoperative chemoradiotherapy is an accepted standard treatment for patients with locally advanced esophageal cancer. Nimotuzumab is a monoclonal antihuman EGFR IgG1 antibody that has demonstrated synergistic activity with both radiotherapy and platinum-based chemotherapy in some solid tumors. The aim of this study is to investigate the safety and efficacy of nimotuzumab in combination with preoperative concurrent chemoradiotherapy for locally advanced esophageal squamous cell carcinoma (ESCC). Methods: Previously untreated patients with stage II-III ESCC received nimotuzumab (200mg per week in weeks1-5), paclitaxel(45 mg/m2 per week in weeks 2-5), cisplatin(20 mg/m2 per week in weeks 2-5) and radiotherapy at a total dose of 40 Gy (2.0Gy/d,5 days per week in weeks 2-5). Esophagectomy was performed 4 weeks after the completion of preoperative strategies. Results: Eighteen eligible patients were enrolled. All patients completed the preoperative regimen, and seventeen patients underwent surgery. The clinical response rate was 94.4% (17/18). The most frequent Grade 1/2 toxicities were esophagitis(12/17), leukocytopenia(14/17), nausea/vomiting(8/17) and fatigue(4/17). Grade 3 leukocytopenia was observed in 11.8 % of patients (3/17). The rate of radical resection was 100%, and the pathological complete response rate was 41.2%(7/17). Downstaging occurred in 15/17 (88.2 %) patients by T stage and 8/17 (47.1%) by N stage. The incidences of postoperative anastomotic leak, pulmonary infection, hoarseness and arrhythmia were 11.8%, 11.8%, 5.9%, and 5.9%, respectively. No perioperative deaths occurred in the study. Conclusions: The regimen of nimotuzumab in combination with preoperative concurrent chemoradiotherapy is safe for locally advanced ESCC. The preoperative strategy is able to achieve substantially high clinical response rate and pathological complete response rate.

The effect of MRI or PET fusion in radiotherapy treatment planning on the pathological complete response rate in rectal adenocarcinoma.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 523-523
Author(s):  
Zaker Hamid Rana ◽  
Robert Hong ◽  
Joon Han ◽  
Isaac Chen ◽  
Mohammed Nurhussien ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Treatment Planning ◽  
Response Rate ◽  
Pathological Complete Response ◽  
Complete Response Rate ◽  
Rectal Adenocarcinoma ◽  
Complete Response ◽  
Preoperative Chemoradiation ◽  
Pathological Response ◽  
Complete Pathological Response

523 Background: A pathological complete response rate of 10% to 30% has been noted to occur following preoperative chemoradiation with CT-based treatment planning in patients with rectal cancer. Fusion of the treatment planning CT with other imaging modalities like MRI or PET may help identify tumor location and improve tumor coverage. This retrospective study sought to evaluate the effect of adding MRI or PET imaging to CT-based treatment planning and its impact on pathological complete response rates in patients with rectal cancer. Methods: A retrospective analysis was performed on 39 patients, who received neoadjuvant chemoradiation for rectal adenocarcinoma from February 2009 to September 2013. Patients were divided into two groups. The first group was treated using CT-only based treatment 3D-Conformal or IMRT planning (n=9) and the second was treated using either PET or MRI fusion with the simulation CT scan (n=30). Patients were treated to a total of 5,040 cGy in 28 fractions. Pathological complete response rates (ypT0N0M0) were assessed using postoperative pathologic reports following resection. Results: 39 patients with a median age of 62 received preoperative chemoradiation with an interval to surgery ranging from 34-162 days and a median of 70 days. Patients treated with PET or MRI fusion treatment planning showed a complete pathological response rate at the primary site of 60% and a complete lymph node pathological response rate of 70.83% compared to 22.22% at the primary site and 66.66% at lymph node sites in patients with CT-only treatment planning. In patients treated using MRI or PET fusion, middle rectal cancer showed the best complete pathological response rate at 80%, followed by lower rectal cancer at 41.66%, and upper rectal cancer at 37.5%. Conclusions: Although the sample size was small, utilization of MRI or PET fusion resulted in a higher pathological complete response rate when compared to CT-only based treatment planning, especially in middle rectal cancers. Further studies are needed to accurately identify those patients with a complete pathologic response which may ultimately alter their treatment course.

Open label, non randomized, interventional study to evaluate response rate after induction therapy with docetaxel and cisplatin in unresectable locally advanced squamous cell carcinoma of head and neck (NCT02061631).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17513-e17513
Author(s):  
S. H. Manzoor Zaidi ◽  
Ahmed I. Masood ◽  
Syed Ijaz Hussain Shah ◽  
Irfan Hashemy
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Response Rate ◽  
Locally Advanced ◽  
Complete Response ◽  
Hematological Toxicity ◽  
Advanced Squamous Cell Carcinoma ◽  
Open Label ◽  
Induction Regimen

e17513 Background: This single arm, multicenter, phase 2 study was conducted to evaluate overall response (OR) rate and safety of subjects treated with induction regimen docetaxel + cisplatin, followed by chemoradiotherapy (CRT), in patients with locally advanced squamous cell carcinoma of oral cavity (stage III or IV) without distant metastasis. Methods: Induction regimen consisted of docetaxel 75mg/m2 and cisplatin 75mg/m2 on day 1; cycles were repeated every 21 days for 3 cycles with supportive G-CSF treatment beginning at first cycle. CRT consisted of weekly cisplatin 30mg/m2 for 4 weeks starting concomitantly with 60 Gy/30 fractions of conventional radiotherapy for 6 weeks. Primary and secondary efficacy criteria were OR rate at 3 weeks after cycle 3 and 8 weeks after last cycle of CRT respectively. Results: Three centers enrolled 35 patients. Primary efficacy endpoint: OR rate of evaluable patients (n = 27) was 88.9% (95% CI:71.9-96.2). Complete response (CR) was not achieved by any patients; partial response (PR) was achieved by 88.9% (24 of 27). From intent to treat (ITT) analysis OR rate was 68.6% (24 of 35). Secondary efficacy endpoint: OR rate of evaluable patients (n = 19) was 78.9% (95% CI:56.7-91.5) with CR and PR achieved by 2 (10.5%) and 13 (68.4%) patients respectively. Progressive disease (PD) was present in 4 patients. From ITT analysis CR rate was 5.7% (2 of 35) and OR rate was 42.9% (15 of 35). During induction most common hematological toxicity was leukopenia in 8 patients, with ≥Grade 3 leukopenia in 3 patients. Common non hematologic toxicities (all grades) were nausea, stomatitis and alopecia in 21, 18 and 18 patients respectively. During CRT most common adverse events were alopecia, stomatitis and nausea in 14, 13 and 13 patients respectively. Overall, leukopenia met seriousness criteria in 4 patients, and there was 1 case of febrile neutropenia. Overall, 7 patients died. Fatal events were not associated to investigational drugs. Conclusions: We observed an ITT response rate of 68.6% with docetaxel + cisplatin, suggestive of an active induction regimen with manageable safety profile. Clinical trial information: NCT02061631.

756 LONG-TERM OUTCOME AFTER ENDOSCOPIC SUBMUCOSAL DISSECTION FOR ENTIRE CIRCUMFERENTIAL CT1AN0M0 ESOPHAGEAL SQUAMOUS CELL CARCINOMA

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Atsushi Inaba ◽  
Tomohiro Kadota ◽  
Keiichiro Nishihara ◽  
Daiki Sato ◽  
Keiichiro Nakajo ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Curative Resection ◽  
Response Rate ◽  
Complete Response Rate ◽  
Complete Response ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Stricture Rate

Abstract   Endoscopic submucosal dissection (ESD) is the standard treatment for cT1a esophageal squamous cell carcinoma (ESCC), however its indication for the entire circumferential lesions is still controversial because of the risk of severe stricture after ESD. Therefore, several treatment options are performed based on physicians’ choice, however, each clinical course is unclear. This study aimed to clarify the long-term outcome after ESD for patients with entire circumferential cT1aN0M0 ESCC, comparing with esophagectomy or chemoradiotherapy. Methods Patients with entire circumferential cT1aN0M0 SESCC treated with ESD, chemoradiotherapy, or esophagectomy as the initial treatment between January 2010 and December 2016 in our institution were included. Patients who had a history of any malignancy at cStage II-IV within 5 years were excluded. The 5-year overall survival (OS), 5-year disease-free survival (DFS), stricture rate, refractory stricture rate (defined as requiring >6 dilations), curative resection (defined as pT1a without lymphovascular invasion and negative for vertical margin in the pathological evaluation) rate of ESD, and complete response rate of chemoradiotherapy were evaluated for each treatment. Results Of the 48 eligible patients, 25/13/10 patients were performed ESD/chemoradiotherapy/esophagectomy as an initial treatment. Curative resections rate of ESD was 72%, and additional esophagectomy and chemoradiotherapy were performed in three and one patients with non-curative resection. Complete response rate of chemoradiotherapy was 100%, however, 4 patients had recurrence thereafter. No recurrences occurred after esophagectomy in all patients treated with esophagectomy. During median follow-up of 83 months, stricture and refractory stricture rate was 80/44% after ESD, 0/0% after chemoradiotherapy, and 20/10% after esophagectomy. The 5-year OS/DFS was 91/87% after ESD, 92/59% after chemoradiotherapy, and 90/90% after esophagectomy. Conclusion While some patients required additional treatments due to non-curative resection, the long-term survival after ESD for circumferential cT1aN0M0 ESCC was similar as those after chemoradiotherapy or esophagectomy. In contrast, the stricture and refractory stricture rate after ESD was higher than others. Further investigation in a large cohort is necessary to clarify the indication criteria of ESD for patients with the lesion.

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