BACKGROUND AND PURPOSE: For definitive radiochemotherapy, 5-fluorouracil/cisplatin protocols have been considered the standard of care for esophageal carcinoma over the last 2 decades. By contrast, most patients treated at the University Hospital, LMU Munich, Germany, received 5-fluorouracil/mitomycin C. The objective of this retrospective analysis was to determine the value of 5-fluorouracil/mitomycin-C-based therapy. PATIENTS AND METHODS: Tumor stage, treatment received, and outcome data of patients treated for esophageal cancer between 1982 and 2007 were collected; endpoint of the analysis was overall survival. RESULTS: 298 patients with inoperable cancer of the esophagus were identified (16.8% adenocarcinoma, 77.5% squamous cell carcinoma). At diagnosis, 61.7% (184/298) had UICC stage III-IV, 54.4% (162/298) positive lymph nodes, and 26.5% (79/298) metastatic disease. 74.5% of all patients (222/298) received radiation doses between 55 and 65 Gy, 65.8% (196/298) were subjected to concomitant chemotherapy. The median follow-up period (patients alive) was 4.1 years. A significant increase of overall survival (p < 0.0001) in the radiochemotherapy versus the radiotherapy-alone group was observed. 52% (102/196) in the 5-fluorouracil/ mitomycin C group had tumor stages comparable to the RTOG 85-01 study cohort (T1-3 N0-1 M0). The median survival in this subgroup was 18.2 months, 3- and 5-year survival rates were 22.7% (21/102) and 15.0% (13/102), respectively. CONCLUSION: Despite being nominally inferior to platinum-based radiochemotherapy, the overall survival rates are in a similar range. Thus, the mitomycin-C-based radiochemotherapy approach may considered to be as effective as the standard therapy. However, there is no randomized trial available in order to prove the equality.
BACKGROUND AND PURPOSE: For definitive radiochemotherapy, 5-fluorouracil/cisplatin protocols have been considered the standard of care for esophageal carcinoma over the last 2 decades. By contrast, most patients treated at the University Hospital, LMU Munich, Germany, received 5-fluorouracil/mitomycin C. The objective of this retrospective analysis was to determine the value of 5-fluorouracil/mitomycin-C-based therapy. PATIENTS AND METHODS: Tumor stage, treatment received, and outcome data of patients treated for esophageal cancer between 1982 and 2007 were collected; endpoint of the analysis was overall survival. RESULTS: 298 patients with inoperable cancer of the esophagus were identified (16.8% adenocarcinoma, 77.5% squamous cell carcinoma). At diagnosis, 61.7% (184/298) had UICC stage III-IV, 54.4% (162/298) positive lymph nodes, and 26.5% (79/298) metastatic disease. 74.5% of all patients (222/298) received radiation doses between 55 and 65 Gy, 65.8% (196/298) were subjected to concomitant chemotherapy. The median follow-up period (patients alive) was 4.1 years. A significant increase of overall survival (p < 0.0001) in the radiochemotherapy versus the radiotherapy-alone group was observed. 52% (102/196) in the 5-fluorouracil/ mitomycin C group had tumor stages comparable to the RTOG 85-01 study cohort (T1-3 N0-1 M0). The median survival in this subgroup was 18.2 months, 3- and 5-year survival rates were 22.7% (21/102) and 15.0% (13/102), respectively. CONCLUSION: Despite being nominally inferior to platinum-based radiochemotherapy, the overall survival rates are in a similar range. Thus, the mitomycin-C-based radiochemotherapy approach may considered to be as effective as the standard therapy. However, there is no randomized trial available in order to prove the equality.
Authors: T.B. Brunner; G.G. Grabenbauer; S. Kastl; O. Herrmann; U. Baum; R. Fietkau; P. Klein; W. Bautz; T. Schneider; W. Hohenberger; R. Sauer Journal: Onkologie Date: 2000-10
Authors: Volker Budach; Martin Stuschke; Wilfried Budach; Michael Baumann; Dirk Geismar; Gerhard Grabenbauer; Ingrid Lammert; Klaus Jahnke; Georg Stueben; Thomas Herrmann; Michael Bamberg; Peter Wust; Wolfgang Hinkelbein; Klaus-Dieter Wernecke Journal: J Clin Oncol Date: 2005-02-20 Impact factor: 44.544
Authors: M al-Sarraf; K Martz; A Herskovic; L Leichman; J S Brindle; V K Vaitkevicius; J Cooper; R Byhardt; L Davis; B Emami Journal: J Clin Oncol Date: 1997-01 Impact factor: 44.544
Authors: A P Andersen; P Berdal; F Edsmyr; S Hagen; R Hatlevoll; K Nygaard; P Ottosen; P Peterffy; H Kongsholm; K Elgen Journal: Radiother Oncol Date: 1984-10 Impact factor: 6.280
Authors: B H Burmeister; J W Denham; M O'Brien; G G Jamieson; P G Gill; P Devitt; E Yeoh; C S Hamilton; S P Ackland; D S Lamb Journal: Int J Radiat Oncol Biol Phys Date: 1995-07-15 Impact factor: 7.038
Authors: Bernhard J Leibl; Stephanie Vitz; Wolfgang Schäfer; Martin Alfrink; Andreas Gschwendtner; Gerhard G Grabenbauer Journal: Strahlenther Onkol Date: 2011-03-24 Impact factor: 3.621
Authors: Adrian Staab; Markus Fleischer; Juergen Loeffler; Harun M Said; Astrid Katzer; Christian Plathow; Herrmann Einsele; Michael Flentje; Dirk Vordermark Journal: Strahlenther Onkol Date: 2011-03-25 Impact factor: 3.621