TY - JOUR
T1 - The role of definitive chemoradiation in patients with non-metastatic oesophageal cancer
AU - Jeene, Paul M.
AU - van Laarhoven, Hanneke W. M.
AU - Hulshof, Maarten C. C. M.
PY - 2018
Y1 - 2018
N2 - Definitive chemoradiation (dCRT) is a curative treatment option for patients with oesophageal cancer. It is effective in both adenocarcinoma and squamous cell carcinoma. However, locoregional control is less after dCRT compared to preoperative CRT (pCRT) followed by surgery. Also, overall survival is lower compared to pCRT followed by surgery, which can only partly be explained by a negative selection of patients. The optimal dose of radiotherapy remains to be determined, but dose escalation above 50.4Gy might be beneficial. Cisplatinum/5-FU is the most applied concurrent chemotherapy, but carboplatin/paclitaxel seems equally effective with less toxicity. The addition of 5-FU to a taxane and platinum seems promising. Accelerated fractionation and addition of cetuximab did not improve results. dCRT is a successful treatment for regional lymph node recurrences, but less so for recurrences at the anastomotic site. Re-irradiation after prior curative radiotherapy yields poor results. dCRT can be safely used in carefully selected elderly.
AB - Definitive chemoradiation (dCRT) is a curative treatment option for patients with oesophageal cancer. It is effective in both adenocarcinoma and squamous cell carcinoma. However, locoregional control is less after dCRT compared to preoperative CRT (pCRT) followed by surgery. Also, overall survival is lower compared to pCRT followed by surgery, which can only partly be explained by a negative selection of patients. The optimal dose of radiotherapy remains to be determined, but dose escalation above 50.4Gy might be beneficial. Cisplatinum/5-FU is the most applied concurrent chemotherapy, but carboplatin/paclitaxel seems equally effective with less toxicity. The addition of 5-FU to a taxane and platinum seems promising. Accelerated fractionation and addition of cetuximab did not improve results. dCRT is a successful treatment for regional lymph node recurrences, but less so for recurrences at the anastomotic site. Re-irradiation after prior curative radiotherapy yields poor results. dCRT can be safely used in carefully selected elderly.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85057025596&origin=inward
U2 - https://doi.org/10.1016/j.bpg.2018.11.011
DO - https://doi.org/10.1016/j.bpg.2018.11.011
M3 - Article
C2 - 30551857
SN - 1521-6918
VL - 36-37
SP - 53
EP - 59
JO - Best practice & research. Clinical gastroenterology
JF - Best practice & research. Clinical gastroenterology
ER -