Neoadjuvant chemoradiotherapy with volumetric-modulated arc therapy for medium-distal oesophageal and gastro-oesophageal junction carcinoma

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Abstract

Aim: to appraise the role of volumetric-modulated arc therapy (VMAT) in the neoadjuvant chemoradiotherapy management of advanced medium and distal oesophageal cancer in terms of toxicity and response to treatment. Patients and Methods: Thirty patients were treated according to the neoadjuvant chemoradiation followed by surgery versus surgery-alone trial scheme with VMAT radiation therapy. Patients presented mainly T3-T4 stage (80%) and N1-2 (96.6%) disease. The chemotherapy scheme consisted of 3-5 cycles, while a radiotherapy course of 41.4 Gy in 23 fractions was administered to all patients. Results: The median age of patients was 65 years, and there was a predominance of males (80%), smokers or ex-smokers (90%) and modest alcohol habit (80% negative). Primary tumor localisation was in the medium and distal third of the oesophagus in 57% of the cases, the rest being in the gastro-oesophageal junction. Modest toxicity profiles were observed, with limited incidence of grade 2-3 events. Partial or complete response was observed in more than 90% of the cases (radiological/metabolic) and was confirmed after surgical intervention (67% partial or complete and 27% stable response). Tumor down-staging was recorded in 67% of patients and nodal down-staging in 50%. Conclusion: VMAT was applied in the context of neoadjuvant chemoradiotherapy for the treatment of medium and distal oesophageal carcinoma with satisfactory results in terms of tolerance and toxicity.

Original languageEnglish
Pages (from-to)4109-4116
Number of pages8
JournalAnticancer Research
Volume35
Issue number7
Publication statusPublished - Jul 1 2015

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Intensity-Modulated Radiotherapy
Chemoradiotherapy
Carcinoma
Radiotherapy
Neoadjuvant Therapy
Neoplasm Staging
Esophageal Neoplasms
Esophagus
Habits
Alcohols
Drug Therapy
Incidence
Neoplasms

Keywords

  • Neoajuvant radiochemotherapy
  • Oesophageal cancer
  • RapidArc

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

@article{2d2046828c834ce1b6525e0bbd3ab0c8,
title = "Neoadjuvant chemoradiotherapy with volumetric-modulated arc therapy for medium-distal oesophageal and gastro-oesophageal junction carcinoma",
abstract = "Aim: to appraise the role of volumetric-modulated arc therapy (VMAT) in the neoadjuvant chemoradiotherapy management of advanced medium and distal oesophageal cancer in terms of toxicity and response to treatment. Patients and Methods: Thirty patients were treated according to the neoadjuvant chemoradiation followed by surgery versus surgery-alone trial scheme with VMAT radiation therapy. Patients presented mainly T3-T4 stage (80{\%}) and N1-2 (96.6{\%}) disease. The chemotherapy scheme consisted of 3-5 cycles, while a radiotherapy course of 41.4 Gy in 23 fractions was administered to all patients. Results: The median age of patients was 65 years, and there was a predominance of males (80{\%}), smokers or ex-smokers (90{\%}) and modest alcohol habit (80{\%} negative). Primary tumor localisation was in the medium and distal third of the oesophagus in 57{\%} of the cases, the rest being in the gastro-oesophageal junction. Modest toxicity profiles were observed, with limited incidence of grade 2-3 events. Partial or complete response was observed in more than 90{\%} of the cases (radiological/metabolic) and was confirmed after surgical intervention (67{\%} partial or complete and 27{\%} stable response). Tumor down-staging was recorded in 67{\%} of patients and nodal down-staging in 50{\%}. Conclusion: VMAT was applied in the context of neoadjuvant chemoradiotherapy for the treatment of medium and distal oesophageal carcinoma with satisfactory results in terms of tolerance and toxicity.",
keywords = "Neoajuvant radiochemotherapy, Oesophageal cancer, RapidArc",
author = "Angelo Tozzi and Cristina Iftode and Luca Cozzi and Ascolese, {Anna Maria} and Serena Battista and Raffaele Cavina and Elena Clerici and Tiziana Comito and D'Agostino, {Giuseppe R.} and {De Rose}, Fiorenza and Ciro Franzese and Isabella Garassino and Romario, {Uberto Fumagalli} and Pierina Navarria and Riccardo Rosati and Paola Spaggiari and Stefano Tomatis and Marta Scorsetti",
year = "2015",
month = "7",
day = "1",
language = "English",
volume = "35",
pages = "4109--4116",
journal = "Anticancer Research",
issn = "0250-7005",
publisher = "International Institute of Anticancer Research",
number = "7",

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TY - JOUR

T1 - Neoadjuvant chemoradiotherapy with volumetric-modulated arc therapy for medium-distal oesophageal and gastro-oesophageal junction carcinoma

AU - Tozzi, Angelo

AU - Iftode, Cristina

AU - Cozzi, Luca

AU - Ascolese, Anna Maria

AU - Battista, Serena

AU - Cavina, Raffaele

AU - Clerici, Elena

AU - Comito, Tiziana

AU - D'Agostino, Giuseppe R.

AU - De Rose, Fiorenza

AU - Franzese, Ciro

AU - Garassino, Isabella

AU - Romario, Uberto Fumagalli

AU - Navarria, Pierina

AU - Rosati, Riccardo

AU - Spaggiari, Paola

AU - Tomatis, Stefano

AU - Scorsetti, Marta

PY - 2015/7/1

Y1 - 2015/7/1

N2 - Aim: to appraise the role of volumetric-modulated arc therapy (VMAT) in the neoadjuvant chemoradiotherapy management of advanced medium and distal oesophageal cancer in terms of toxicity and response to treatment. Patients and Methods: Thirty patients were treated according to the neoadjuvant chemoradiation followed by surgery versus surgery-alone trial scheme with VMAT radiation therapy. Patients presented mainly T3-T4 stage (80%) and N1-2 (96.6%) disease. The chemotherapy scheme consisted of 3-5 cycles, while a radiotherapy course of 41.4 Gy in 23 fractions was administered to all patients. Results: The median age of patients was 65 years, and there was a predominance of males (80%), smokers or ex-smokers (90%) and modest alcohol habit (80% negative). Primary tumor localisation was in the medium and distal third of the oesophagus in 57% of the cases, the rest being in the gastro-oesophageal junction. Modest toxicity profiles were observed, with limited incidence of grade 2-3 events. Partial or complete response was observed in more than 90% of the cases (radiological/metabolic) and was confirmed after surgical intervention (67% partial or complete and 27% stable response). Tumor down-staging was recorded in 67% of patients and nodal down-staging in 50%. Conclusion: VMAT was applied in the context of neoadjuvant chemoradiotherapy for the treatment of medium and distal oesophageal carcinoma with satisfactory results in terms of tolerance and toxicity.

AB - Aim: to appraise the role of volumetric-modulated arc therapy (VMAT) in the neoadjuvant chemoradiotherapy management of advanced medium and distal oesophageal cancer in terms of toxicity and response to treatment. Patients and Methods: Thirty patients were treated according to the neoadjuvant chemoradiation followed by surgery versus surgery-alone trial scheme with VMAT radiation therapy. Patients presented mainly T3-T4 stage (80%) and N1-2 (96.6%) disease. The chemotherapy scheme consisted of 3-5 cycles, while a radiotherapy course of 41.4 Gy in 23 fractions was administered to all patients. Results: The median age of patients was 65 years, and there was a predominance of males (80%), smokers or ex-smokers (90%) and modest alcohol habit (80% negative). Primary tumor localisation was in the medium and distal third of the oesophagus in 57% of the cases, the rest being in the gastro-oesophageal junction. Modest toxicity profiles were observed, with limited incidence of grade 2-3 events. Partial or complete response was observed in more than 90% of the cases (radiological/metabolic) and was confirmed after surgical intervention (67% partial or complete and 27% stable response). Tumor down-staging was recorded in 67% of patients and nodal down-staging in 50%. Conclusion: VMAT was applied in the context of neoadjuvant chemoradiotherapy for the treatment of medium and distal oesophageal carcinoma with satisfactory results in terms of tolerance and toxicity.

KW - Neoajuvant radiochemotherapy

KW - Oesophageal cancer

KW - RapidArc

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M3 - Article

C2 - 26124363

AN - SCOPUS:84937108463

VL - 35

SP - 4109

EP - 4116

JO - Anticancer Research

JF - Anticancer Research

SN - 0250-7005

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