Endoscopic resection with selective CRT effective for oesophageal squamous cell carcinoma
The combination of endoscopic resection (ER) and selective chemoradiotherapy (CRT) is effective for stage T1b N0M0 thoracic oesophageal squamous cell carcinoma (ESCC), a recent study has found.
Researchers prospectively assessed 176 patients (median age, 63 years; 147 males) with T1b N0M0 thoracic ESCC who underwent ER. Based on resection findings, participants received one of three therapy regimens: no additional treatment (group A; n=74), prophylactic CRT at 41.4 Gy delivered to locoregional lymph nodes (group B; n=83) and definitive CRT at 50.4 Gy with a 9-Gy boost to the primary site (group C; n=13).
The 3-year overall survival rate in group B, the study’s primary outcome, was 90.7 percent (90 percent CI, 84.0–94.7). In the overall sample, the corresponding rate was 92.6 percent (88.5–95.2). This indicated that CRT was either comparable to or superior than surgical intervention, said researchers.
Fifteen patients developed metastatic recurrence of the malignancy, including one in group A, 10 in group B and four in group C. Seven patients with recurrent cancer in only the lymph nodes received salvage surgery; two were alive at the final follow-up. The 3-year progression-free survival rate for the overall sample was 89.7 percent.
There were 18 deaths over the entire study period, though none were related to the treatment regimen. Oesophageal cancer was responsible for 11 deaths, including one in group A, seven in group B and three in group C. Other (brain haemorrhage, acute pancreatitis and pneumonia, among others) and unknown causes accounted for the remaining mortalities.