Involved-Field Irradiation in Definitive Chemoradiotherapy for Locoregional Esophageal Squamous Cell Carcinoma: Results From the ESO-Shanghai 1 Trial - Sorbonne Université
Journal Articles International Journal of Radiation Oncology, Biology, Physics Year : 2021

Involved-Field Irradiation in Definitive Chemoradiotherapy for Locoregional Esophageal Squamous Cell Carcinoma: Results From the ESO-Shanghai 1 Trial

Hongcheng Zhu
  • Function : Author
Jinjun Ye
  • Function : Author
Charles B Simone
  • Function : Author
Zhengfei Zhu
  • Function : Author
Weixin Zhao
  • Function : Author
Arya Amini
  • Function : Author
Jialiang Zhou
  • Function : Author
Huarong Tang
  • Function : Author
Min Fan
  • Function : Author
Qin Lin
  • Function : Author
Yi Xia
  • Function : Author
Jiancheng Li
  • Function : Author
Miao Mo
  • Function : Author
Huixun Jia
  • Function : Author
Saiquan Lu
  • Function : Author
Juanqi Wang
  • Function : Author
Yongzhan Nie
  • Function : Author
Junqiang Chen
  • Function : Author
Shixiu Wu
  • Function : Author
Masatsugu Hamaji
  • Function : Author
Waqar Haque
  • Function : Author
Bae Kwon Jeong
  • Function : Author
Ravi Shridhar
  • Function : Author
Zhen Zhang
  • Function : Author
Yun Chen
  • Function : Author
  • PersonId : 1160390
Kuaile Zhao
  • Function : Author
  • PersonId : 1160391

Abstract

Purpose: To evaluate the feasibility and efficacy of involved-field irradiation in definitive chemoradiation therapy for locoregional esophageal squamous cell carcinoma. Methods and Materials: Patterns in recurrence and elective nodal failure were analyzed in patients from the previously published ESO-Shanghai 1 trial, who received definitive chemoradiation therapy with involved-field irradiation to 61.2 Gy in 34 fractions using intensity modulated radiation therapy planning. Nodal regions were delineated using the lymph node map from the sixth edition of the American Joint Committee on Cancer staging system. Elective nodal failure was defined as recurrence in the regional nodal area outside the planning target volume. Extensive elective nodal failure, defined as an extensive nodal area regardless of tumor location, was calculated for additional analysis. The incidental (ie, mean) irradiation dose of each node and each region was evaluated. Results: With a median follow-up of 48.7 months among survivors, the 3-year actuarial rate for overall survival was 53.6%, and the median overall survival was 44.8 months (95% confidence interval, 34.6-55.0). Of the 436 patients included in this study, 258 patients (59.2%) experienced treatment failure. Elective nodal failure was experienced by 37 patients (8.5%), 7 (1.6%) of whom encountered nodal-only failure. The 3-year actuarial rates of elective nodal control and elective nodalonly control were 89.7% and 97.9%, respectively. The median incidental dose of these nodes was 33.2 Gy (interquartile range [IQR], 1.3-50.7 Gy). The median distance of each node to the planning target volume was 1.4 cm (IQR, 0.6-4.9 cm). Extensive elective nodal failure was experienced by 51 patients (11.6%), and 20 (4.6%) patients had nodal-only failure. The 3-year extensive elective nodal control and extensive elective nodal control-only rates were 86.0% and 94.3%, respectively. The median incidental dose of these nodes was 23.2 Gy (IQR, 1.1-53.5 Gy). The median distance of each node to the planning target volume was 2.0 cm (IQR, 0.6-5.5 cm). Conclusion: Involved-field irradiation can achieve a low rate of isolated nodal failure and a satisfactory survival outcome. The use of elective nodal irradiation may be unnecessary in definitive chemoradiation therapy for the treatment of locoregional esophageal squamous cell carcinoma.
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Dates and versions

hal-03767833 , version 1 (16-02-2023)

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Hongcheng Zhu, Eleonor Rivin del Campo, Jinjun Ye, Charles B Simone, Zhengfei Zhu, et al.. Involved-Field Irradiation in Definitive Chemoradiotherapy for Locoregional Esophageal Squamous Cell Carcinoma: Results From the ESO-Shanghai 1 Trial. International Journal of Radiation Oncology, Biology, Physics, 2021, 110 (5), pp.1396-1406. ⟨10.1016/j.ijrobp.2021.02.053⟩. ⟨hal-03767833⟩
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