Advertisement

Multimodal Treatment: Early and Long-term Results and Recurrences

  • Antonio Grandinetti
Part of the Updates in Surgery book series (UPDATESSURG)

Abstract

In the past, the treatment of choice for hypopharyngeal and cervical squamous cell carcinoma (SCC) was radiotherapy alone, administered over large fields and using what have now become obsolete techniques. The early and late outcomes and quality of life of these patients were disappointing, since many often required additional palliative surgical treatment to control dysphagia or complications associated with radiotherapy (RT). A major advance occurred in 1960, with the adoption of pharyngolaryngoesophagectomy (PLE), with or without adjuvant RT, as the standard surgical approach for cervical esophageal carcinoma (CEC) [1]. However, despite significant improvements over the following decades, PLE has a high morbidity (49%) and mortality (9%), and the quality of life is compromised by “en bloc” laryngectomy [2].

Keywords

Intensity Modulate Radiation Therapy Gross Tumor Volume Cervical Squamous Cell Carcinoma Intensity Modulate Radiation Therapy Plan Larynx Preservation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Ong GB, Lee TC (1960) Pharyngogastric anastomosis after oesophagopharyngectomy for carcinoma of the hypopharynxand cervical oesophagus. Br J Surg 48:193–200PubMedCrossRefGoogle Scholar
  2. 2.
    Tong DKH, Law S, Wan Kwong DL et al (2011) Current management of cervical esophageal cancer. World J Surg 35:600–607PubMedCrossRefGoogle Scholar
  3. 3.
    Department of Veterans Affairs Laryngeal Cancer Study Group (1991) Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Eng J Med 324:1685–1690CrossRefGoogle Scholar
  4. 4.
    Bernier J, Domenge C, Ozsahin M et al (2004) Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 350:1945–1952PubMedCrossRefGoogle Scholar
  5. 5.
    Zieren HU, Müller JM, Jacobi CA et al (1995) Adjuvant postoperative radiation therapy after curative resection of squamous esophageal cell carcinoma: a prospective randomized study. World J Surg 19:444–449PubMedCrossRefGoogle Scholar
  6. 6.
    Xiao ZF, Yang ZY, Miao YJ et al (2005) Influence of number of metastatic lymph nodes on survival of curative resected thoracic esophageal cancer patients and value of radiotherapy: report of 549 cases. Int J Radiat Oncol Biol Phys 62:82–90PubMedCrossRefGoogle Scholar
  7. 7.
    Wang HW, Chu PY, Kuo KT et al (2006) A reappraisal of surgical management for squamous cell carcinoma in the pharyngoesophageal junction. J Surg Oncol 93:468–476PubMedCrossRefGoogle Scholar
  8. 8.
    Ando N, Iizuka T, Ide H et al (2003) Surgery plus chemotherapy compared with surgery alone for squamous cell carcinoma of the esophagus: a Japan Clinical Oncology Group Study. J Clin Oncol 21:4592–4596PubMedCrossRefGoogle Scholar
  9. 9.
    MacDonaldZ JS, Smalley SR et al (2001) Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Eng J Med 345:725–730CrossRefGoogle Scholar
  10. 10.
    Bedard EL, Inculet RI, Malthaner RA et al (2001) The role of surgery and postoperative chemoradiation therapy in patients with lymph node positive esophageal carcinoma. Cancer 91:2423–2430PubMedCrossRefGoogle Scholar
  11. 11.
    Rice TW, Adelstain DJ, Chidel MA et al (2003) Benefit of postoperative adjuvant chemoradiotherapy in locoregionally advanced esophageal carcinoma. J Thorac Cardiovasc Surg 126:1590–1596PubMedCrossRefGoogle Scholar
  12. 12.
    Liu HC, Hung SK, Huang CJ et al (2005) Esophagectomy for locally advanced esophageal cancer, followed by chemoradiotherapy and adjuvant chemotherapy. World J Gastoenterol 11:5367–5372Google Scholar
  13. 13.
    Dalko H, Hayashi R, Sakuraba M et al (2011) A pilot study of postoperative radiotherapy with concurrent chemotherapy for high-risk squamous cell carcinoma of the cervical esophagus. Japanese J Clin Oncol 41:508–513CrossRefGoogle Scholar
  14. 14.
    Arnott SJ, Duncan W, GignouxZ M et al (2000) Preoperative radiotherapy for esophageal carcinoma. Cochrane database Syst Rev (4):CD001799PubMedGoogle Scholar
  15. 15.
    Kelsen DP, Winter Ka, Gunderson LL et al (2007) Long-term results of RTOG trial 8911 (USA Intergroup 113): a random assignment trial comparison of chemotherapy followed by surgery compared with surgery alone for esophageal cancer. J Clin Oncol 25:3719–3725PubMedCrossRefGoogle Scholar
  16. 16.
    Bancewicz JCP, Clark PI, Smith DB, et al (2002) Surgical resection with or without preoperative chemotherapy in oesophageal cancer: a randomized controlled trial. The Lancet 359:1727–1733CrossRefGoogle Scholar
  17. 17.
    Kok TC, Siersema PD, Lanschot JV et al (1997) Neoadjuvant chemotherapy in operable esophageal squamous cell cancer: final report of a phase III multicenter randomized controlled trial. Proc Am Soc Clin Oncol 16:277Google Scholar
  18. 18.
    Bosset J, Grignoux M, Triboulet J et al (1997) Chemoradiotherapy followed by surgery compared with surgery alone in squamous cell cancer of the esophagus. N Engl J Med 337:161–167PubMedCrossRefGoogle Scholar
  19. 19.
    Urschel JD, Vasan H (2003) A meta-analysis of randomized controlled trials that compared neoadjuvant chemoradiation and surgery to surgery alone for resectable esophageal cancer. Am J Surg 185:538–543PubMedCrossRefGoogle Scholar
  20. 20.
    Urba S, Orringer M, Turrisi A et al (2001) Randomized trial of preoperative chemoradiation versus surgery alone in patients with locoregional esophageal carcinoma. J Clin Oncol 19:305–313PubMedGoogle Scholar
  21. 21.
    Stahl M, Sttuschke M, Lehman N et al (2005 ) Chemoradiation with and without surgery in patients with locally advanced squamous cell carcinoma of the esophagus. J Clin Oncol 23:2310–2317PubMedCrossRefGoogle Scholar
  22. 22.
    Burmeister BH, Smithers BM, Gebski V et al (2005) Surgery alone versus chemoradiotherapy followed by surgery for resectable cancer of the oesophagus: a randomized controlled phase III trial. Lancet Oncol 6:659–668PubMedCrossRefGoogle Scholar
  23. 23.
    Tepper J, Krasna MJ, Niedzwiecki D et al (2008) Phase III trial of trimodality therapy with cisplatin, fluorouracil, radiotherapy, and surgery compared with surgery alone for esophageal cancer: CALGB 9781. J Clin Oncol 26:1086–1092PubMedCrossRefGoogle Scholar
  24. 24.
    Gebski V, Burmeister B, Smithers BM et al (2007) Survival benefits from neoadjuvant chemoradiotherapy or chemotherapy in oesophageal carcinoma:a meta-analysis. Lancet Oncol 8:226–234PubMedCrossRefGoogle Scholar
  25. 25.
    Cooper JS, Guo MD, Herskovic A et al (1999) Chemoradiotherapy of locally advanced esophageal cancer: long term follow-up of a prospective randomized trial (RTOG 85-01). JAMA 281:1623–1627PubMedCrossRefGoogle Scholar
  26. 26.
    Bedenne L, Michel P, Bouche O et al (2007) Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus: FFCD9102. J Clin Oncol 25:1160–1168PubMedCrossRefGoogle Scholar
  27. 27.
    Wang S, Liao Z, Chen Y et al (2006) Esophageal cancer located at the neck and upper thorax treated with concurrent chemoradiation: a single-institution experience. J Thorac Oncol 1:252–259PubMedGoogle Scholar
  28. 28.
    Burmeister BH, Dickie G, Smithers BM et al (2000) Thirty-four patients with carcinoma of the cervical esophagus treated with chemoradiation therapy. Arch Otolaryngol Head and Neck Surg 126:205–208CrossRefGoogle Scholar
  29. 29.
    Soto Parra H, Valente M, BidoliZ P et al (1997) Definitive chemoradiotherapy in cervical esophageal carcinoma. Proc Am Soc Clin Oncol 16:A929Google Scholar
  30. 30.
    Bidoli P, Bajetta E, Stani SC et al (2002) Ten-year survival with chemotherapy and radiotherapy in patients with squamous cell carcinoma of the esophagus. Cancer 94:352–361PubMedCrossRefGoogle Scholar
  31. 31.
    Santoro A, Bidoli P, Salvini PM et al (1993) Larynx preservation with combined chemotherapy plus radiotherapy in upper squamous cell carcinoma of the esophagus. Proc Am Soc Clin Oncol 12 (Abstract 899)Google Scholar
  32. 32.
    Uno T, Isobe K, Kawakami H et al (2007) Concurrent chemoradiation for patients with squamous cell carcinoma of the cervical esophagus. Dis Esophagus 20:12–18PubMedCrossRefGoogle Scholar
  33. 33.
    Minsky BD, Pajak TF, Ginsberg RJ et al (2002) INT0123(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 20:1167–1174PubMedCrossRefGoogle Scholar
  34. 34.
    Jacob J, Seitz JF, Langlois C et al (1999) Definitive concurrent chemoradiation therapy in squamous cell carcinoma of the esophagus: preliminare results of a French randomized trial comparing standard versus split-course irradiation (FN-CLCC-FFCD9305) Proc Am Soc Clin Oncol 18:1035aGoogle Scholar
  35. 35.
    Crehange G, Maingon P, Peignaux K et al (2007) Phase III trial of protracted compared with split-course chemoradiation for esophageal carcinoma: Federation Francophone de Cancerologie Digestive 9102. J Clin Oncol 25:4895–4901PubMedCrossRefGoogle Scholar
  36. 36.
    Moureau-Zabotto L, Touboul E, Lerouge D et al (2005) Impact of CT and 18F-deoxyglucose positron emission tomography image fusion for conformal radiotherapy in esophageal carcinoma. Int J Radiat Oncol Biol Phys 63:340–345PubMedCrossRefGoogle Scholar
  37. 37.
    Wu Q, Mohan R, Morris M et al (2003) Simultaneous integrated boost intensity-modulated radiotherapy for locally advanced head-and-neck squamous cell carcinoma. Int J Radiat Oncol Biol Phys 56:573–585PubMedCrossRefGoogle Scholar
  38. 38.
    Fu WH, Wang LH, Zhou ZM et al (2004) Comparison of conformal and intensity-modulated techniques for simultaneous integrated boost radiotherapy of upper esophageal carcinoma. World J Gastroenterol 10:1098–1102PubMedGoogle Scholar
  39. 39.
    Yorozu A (2005) Radiotherapy for nodal recurrence after chemoradiotherapy for esoophageal carcinoma. Esophagus 2:21–23CrossRefGoogle Scholar
  40. 40.
    Coia LR, Soffen EM, Schultheiss TE et al (1993) Swallowing function in patients with esophageal cancer treated with concurrent radiation and chemotherapy. Cancer 71:281–286PubMedCrossRefGoogle Scholar
  41. 41.
    Hayter CR, Huff-Winters C, Paszat L et al (2000) A prospective trial of short-course radiotherapy plus chemotherapy for palliation of dysphagia from advanced esophageal cancer. Radiother Oncol 56:329–333PubMedCrossRefGoogle Scholar
  42. 42.
    Kassan Z, Wong RK, Ringash J et al (2008) A phase I/II study to evaluate the toxicity and efficacy of accelerated fractionation radiotherapy for the palliation of dysphagia from carcinoma of the oesophagus. Clin Oncol 20:53–60CrossRefGoogle Scholar
  43. 43.
    Wong R, Malthaner R (2006) Combined chemotherapy and radiotherapy (without surgery) compared with radiotherapy alone in localized carcinoma of the esophagus. Cochrane Database Syst Rev (1):CD002092PubMedGoogle Scholar
  44. 44.
    Burt M, Diehl W, Martini N et al (1991) Malignant esophagorespiratory fistula: management options and survival. Ann Thorac Surg 52:1222–1228Google Scholar
  45. 45.
    Gschossmann JM, Bonner JA, Foote RL et al (1993) Malignant tracheoesophageal fistola in patients with esophageal cancer. Cancer 72:1513–1521PubMedCrossRefGoogle Scholar
  46. 46.
    Malik SM, Krasnow SH, Wadleigh RG (1994) Closure of tracheoesophageal fistulas with primary chemotherapy in patients with esophageal cancer. Cancer 73:1321–1323PubMedCrossRefGoogle Scholar
  47. 47.
    Gaspar LE, Nag S, Herskovic A et al (1997) American Brachytherapy Society consensus guidelines or brachitherapy of esophageal cancer. Int J Radiat Oncol Biol Phys 38:127–132PubMedCrossRefGoogle Scholar
  48. 48.
    Homs MY, Steyerberg EW, Eijkenboom WMH et al (2004) Single-dose brachytherapy versus metal stent placement for the palliation of dysphagia from oesophageal cancer: multicenter randomized trial. Lancet 364:1497–1504PubMedCrossRefGoogle Scholar
  49. 49.
    Graham AJ, Shrive FM, Ghali WA et al (2007) Defining the optimal treatment of locally advanced esophageal cancer: a systematic review and decision. analysis.Ann Thorac Surg 83:1257–1264PubMedCrossRefGoogle Scholar
  50. 50.
    Fujita H, Sueyoshi S, Tanaka T et al (2005) Esophagectomy: is it necessary after chemoradiotherapy for a locally advanced T4 esophageal cancer? Prospected nonrandomized trial comparing chemoradiotherapy with surgery versus without surgery. World J Surg 29:25–31PubMedCrossRefGoogle Scholar
  51. 51.
    Tachimori Y, KanamoriZ N, Uemura N et al (2009) Salvage esophagectomy after high-dose chemoradio-therapy for esophageal squamous cell carcinoma. J Thorac Cardiovasc Surg 137:49–54PubMedCrossRefGoogle Scholar
  52. 52.
    Pignon JP, Bourhis J, Domenge C et al (2000) Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer. Lancet 355: 949–955PubMedCrossRefGoogle Scholar
  53. 53.
    Takagawa R, Kunisaki C, Makino H et al (2008) Efficacy of chemoradiotherapy with lowdose cisplatin and continuous infusion of 5-fluorouracil for unresectable squamous cell carcinoma of the esophagus. Dis Esophagus 22:482–489CrossRefGoogle Scholar
  54. 54.
    Akutsu Y, Matsubara H, Shuto K et al (2009) Clinical and pathologic evaluation of the effectiveness of neoadjuvant chemoradiation therapy in advanced esophageal cancer patients. World J Surg 33:1002–1009PubMedCrossRefGoogle Scholar
  55. 55.
    Pasini F, de Manzoni G, Grandinetti A et al (2009) Effect of neoadjuvant combined modality therapy with weekly docetaxel and cisplatin, 5-fluorouracil continuos infusion and concurrent radiotherapy on pathological responce rate in esophageal cancers: a phase II study. J Clin Oncol 27:213s(4548)CrossRefGoogle Scholar
  56. 56.
    Agarwala AK, Hanna N, McCollum A et al (2009) Preoperative cetuximab and radiation (XRT) for patients (pts) with surgically resectable esophageal and gastroesophageal junction (GEJ) carcinomas: a pilot study from the Hoosier Oncology Group and the University of Texas Southwestern. J Clin Oncol 27:216s(4557)CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • Antonio Grandinetti
    • 1
  1. 1.Radiation Oncology UnitBorgo Trento HospitalVeronaItaly

Personalised recommendations