Search

To investigate the clinical outcomes of cervical esophageal carcinoma patients treated with definitive chemoradiotherapy (CRT). The clinical data of 180 patients received concurrent CRT between April 2005 and September 2021 at 17 institutions were retrospectively analyzed. All patients were treated with curative intent CRT. Only patients treated with definitive intent, and squamous histology were analyzed. Patients who were treated with adjuvant or neoadjuvant setting or adenocarcinoma histology were excluded. The primary endpoint was LC, and the secondary endpoints were PFS and OS. Median age was 56 years (range; 26-87 years). Mean tumor size was 4.9 ± 2.1 cm. Majority of patients (60.6%) are female, had extensive T stage (78.9%), and regional lymph node metastasis (60.6%). Median fraction and total radiation doses were 2 Gy (range, 1.8-2.3 Gy) and 60 Gy (45-72 Gy), respectively delivered in median 30 fractions (range, 23-38 fr). Thirty-six patients (20%) were treated with 3-D conformal radiotherapy (RT) and 144 patients (80%) received intensity modulated RT (IMRT). Majority of the patients (49.4%) received concurrent cisplatin-based chemotherapy with a median 5 cycles (range, 1-8). Median follow-up was 20.7 months (range, 2.4-155.2 months). The 2-year OS and PFS rates were 58.7% and 47%, respectively. The 2-year LC was 69.5%. In univariate analysis ECOG performance score (p:0.01) and treatment response (p<0.001) were significant prognostic factors for OS and PFS. In multivariate analysis ECOG score 2 (HR=1.94, 95%CI, 1.18-3.18, p=0.009) and incomplete treatment response (HR=4.42, 95%CI, 2.80-6.99, p<0.001) were independent predictors for worse OS. In multivariate analysis ECOG score 2 (HR=1.73, 95%CI, 1.0.7-3.79, p=0.003) and incomplete treatment response (HR=4.42, 95%CI, 2.88-6.74, p<0.001) were independent predictors for worse PFS. We found that CRT is a safe and effective treatment modality in patients with cervical esophageal carcinoma. The treatment response and patient performance status were predictive for survival. Further prospective studies with larger cohorts are warranted to confirm our findings. [ABSTRACT FROM AUTHOR]

The standard of care for high grade glioma (HGG) treatment consists of postoperative radiotherapy and temozolamide (TMZ). The effect of time between TMZ administration and RT on treatment outcomes is not well defined. The purpose of this study was to examine the interval between oral administration of TMZ and RT, and its effect on treatment outcomes in patients with HGG. The clinical data of 277 patients with HGG treated between 2009 – 2021 at four centers were retrospectively analyzed. The following are the inclusion criteria: Pathologically proven grade ≥3 glial tumors, ≥18 years old, and completion of curative RT with concurrent oral 75 mg/m2/day TMZ. Patients who were unable to take oral TMZ, or had previously been treated with TMZ and/or RT were excluded. The TMZ to RT interval (TRI) was calculated from the time of oral TMZ administration to the time of RT fraction. In relation to the TMZ half-life, the interval time was divided into <2 h and ≥2 h groups. Progression free survival (PFS) is calculated as the time between the end of RT and clinical or radiological progression. Overall survival (OS) is calculated from the time of diagnosis to the last follow-up. The median age was 58 years (range: 19–81). 159 patients (57.4%) were male, while 118 (42.6%) were female. 75.4% of patients had an ECOG performance score (ECOG PS) of 0–1, and 54.5% had gross total resection (GTR). The median fraction and total RT doses were 2 Gy (1.8–3) and 60 Gy (40–60), respectively. The median follow-up was 15.2 months (range: 1.9–75.1) for the entire cohort. Two-year OS and PFS rates were 35% and 15%, respectively. After completion of RT, disease progression occurred in 255 patients (92.1%) at a median of 6.4 months (range, 0.2–64.9). The 2-year OS was 42.8% for patients with a TRI >2 hours and 32% for patients with a time interval of ≤2 hours (p = 0.18). Similarly, there was no statistically significant difference in 2-year PFS between the two groups (12.8% vs. 9%; p = 0.95). Age, ECOG PS, and type of surgery were all significant prognostic factors for OS and PFS in univariate analysis. In multivariate analysis, advanced age [HR = 1.03 (95% CI, 1.01 – 1.04); p<0.001], poor ECOG PS [HR = 2.14 (95% CI, 1.56 – 2.94); p<0.001], and incomplete surgical resection [HR = 1.39 (95% CI, 1.06–1.84); p = 0.02] were independent predictors of poorer OS. Similarly, age [HR = 1.02 (95% CI, 1.01 – 1.03); p = 0.002], ECOG PS [HR = 1.57 (95% CI, 1.17 – 2.09); p = 0.002], and type of surgery [HR = 1.41 (95% CI, 1.10 – 1.80); p = 0.006] were all significant prognostic factors for PFS in multivariate analysis. We found that advanced age, poor performance status, and incomplete surgical resection were all predictive of poor OS and PFS in this current study. However, we were unable to detect a statistically significant effect of the time interval between oral administration of TMZ and RT. Validation of our findings will require a longer follow-up period and randomized trials. [ABSTRACT FROM AUTHOR]