BACKGROUND: : The use of platinum-based chemoradiation for esophageal cancer is routine, but it is unclear which class of cytotoxic are optimum. It was hypothesized that chemoradiotherapy with fluoropyrimidine, taxane, and camptothecin would have preserved or improved efficacy with no compromise in safety. METHODS: : Patients with histologically confirmed, resectable esophageal carcinoma were eligible. In addition to other tests, a baseline endoscopic ultrasonography (EUS) was obtained. Patients were medically fit and had near-normal organ functions. Patients received docetaxel and irinotecan, plus 5-fluorouracil as induction therapy and then the same cytotoxics with 50.4 grays of radiotherapy followed by an attempted surgery. Pathologic complete response (pathCR) at a rate of > or =20% was the primary endpoint. The pathCR and R0 resection were correlated with overall survival (OS). Safety was documented. RESULTS: : Fifty-five patients were enrolled. Seven were women, and the median age was 56 years. Fifty-three (96%) patients had EUST3, and 41 (75%) had EUSN1 disease. Forty-three (78%) patients underwent surgery, 20% achieved a pathCR, and 76.4% underwent an R0 resection. The median survival (n = 55 patients) was 43.3 months (range, 19-75 months). Baseline clinical parameters were not found to be predictive of OS; however, patients with a pathCR (P = .005) and who underwent R0 resection (P < or = .0001) had an improved OS. There was 1 treatment-related postsurgical death reported. Grade 3 or 4 toxicity (graded according to the National Cancer Institute Common Toxicity Criteria [version 2.0]) was observed in 62% of patients. CONCLUSIONS: : The results of the current study documented that this 3-drug, noncisplatin-based chemoradiotherapy was feasible, safe, and active but not better than the published cisplatin-based chemoradiotherapy. A fluoropyrimidine and another cytotoxic (from any class) may be adequate to establish a baseline chemoradiotherapy regimen to combine biologics. Cancer 2010. (c) 2010 American Cancer Society.
BACKGROUND: : The use of platinum-based chemoradiation for esophageal cancer is routine, but it is unclear which class of cytotoxic are optimum. It was hypothesized that chemoradiotherapy with fluoropyrimidine, taxane, and camptothecin would have preserved or improved efficacy with no compromise in safety. METHODS: : Patients with histologically confirmed, resectable esophageal carcinoma were eligible. In addition to other tests, a baseline endoscopic ultrasonography (EUS) was obtained. Patients were medically fit and had near-normal organ functions. Patients received docetaxel and irinotecan, plus 5-fluorouracil as induction therapy and then the same cytotoxics with 50.4 grays of radiotherapy followed by an attempted surgery. Pathologic complete response (pathCR) at a rate of > or =20% was the primary endpoint. The pathCR and R0 resection were correlated with overall survival (OS). Safety was documented. RESULTS: : Fifty-five patients were enrolled. Seven were women, and the median age was 56 years. Fifty-three (96%) patients had EUST3, and 41 (75%) had EUSN1 disease. Forty-three (78%) patients underwent surgery, 20% achieved a pathCR, and 76.4% underwent an R0 resection. The median survival (n = 55 patients) was 43.3 months (range, 19-75 months). Baseline clinical parameters were not found to be predictive of OS; however, patients with a pathCR (P = .005) and who underwent R0 resection (P < or = .0001) had an improved OS. There was 1 treatment-related postsurgical death reported. Grade 3 or 4 toxicity (graded according to the National Cancer Institute Common Toxicity Criteria [version 2.0]) was observed in 62% of patients. CONCLUSIONS: : The results of the current study documented that this 3-drug, noncisplatin-based chemoradiotherapy was feasible, safe, and active but not better than the published cisplatin-based chemoradiotherapy. A fluoropyrimidine and another cytotoxic (from any class) may be adequate to establish a baseline chemoradiotherapy regimen to combine biologics. Cancer 2010. (c) 2010 American Cancer Society.
Authors: Aminah Jatoi; Gamini Soori; Nathan R Foster; Bradley K Hiatt; James A Knost; Tom R Fitch; Matthew D Callister; Francis C Nichols; Tim M Husted; Steven R Alberts Journal: J Thorac Oncol Date: 2010-12 Impact factor: 15.609
Authors: Panteleimon Kountourakis; Arlene M Correa; Wayne L Hofstetter; Jeffrey H Lee; Manoop S Bhutani; David C Rice; Ritsuko Komaki; Dipen M Maru; William A Ross; Ara Vaporciyan; Stephen G Swisher; Jaffer A Ajani Journal: Cancer Date: 2010-10-19 Impact factor: 6.860
Authors: Matthew D Wood; Bassem I Zaki; Stuart R Gordon; John E Sutton; Mikhail Lisovsky; Jiang Gui; Jeffrey A Bubis; Konstantin H Dragnev; James R Rigas Journal: J Thorac Oncol Date: 2013-04 Impact factor: 15.609
Authors: J A Ajani; A M Correa; W L Hofstetter; D C Rice; M A Blum; A Suzuki; T Taketa; J Welsh; S H Lin; J H Lee; M S Bhutani; W A Ross; D M Maru; H A Macapinlac; J Erasmus; R Komaki; R J Mehran; A A Vaporciyan; S G Swisher Journal: Ann Oncol Date: 2012-07-24 Impact factor: 32.976
Authors: Kazuki Sudo; Takashi Taketa; Arlene M Correa; Maria-Claudia Campagna; Roopma Wadhwa; Mariela A Blum; Ritsuko Komaki; Jeffrey H Lee; Manoop S Bhutani; Brian Weston; Heath D Skinner; Dipen M Maru; David C Rice; Stephen G Swisher; Wayne L Hofstetter; Jaffer A Ajani Journal: J Clin Oncol Date: 2013-10-21 Impact factor: 44.544
Authors: Anhui Shi; Zhongxing Liao; Pamela K Allen; Linus Ho; Mariela Blum Murphy; Dipen M Maru; Stephen G Swisher; Wayne L Hofstetter; Reza J Mehran; James D Cox; Ritsuko Komaki; Steven H Lin Journal: Adv Radiat Oncol Date: 2017-04-19