Use of Chemoradiotherapy as a Treatment Option for Patients with Limited-Stage Primary Small Cell Carcinoma of the Esophagus
Received 14 October 2020
Accepted for publication 25 December 2020
Published 25 January 2021 Volume 2021:13 Pages 613—623
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Harikrishna Nakshatri
Kaikai Zhao,1 Zhaoqin Huang,2 Youjiao Si,3 Liangchao Sun,4 Jinming Yu,4 Xiangjiao Meng4
1Department of Radiation Oncology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, People’s Republic of China; 2Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China; 3Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, People’s Republic of China; 4Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, People’s Republic of China
Correspondence: Xiangjiao Meng
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, People’s Republic of China
Tel +86 13793150996
Purpose: Currently, there are no standard treatments for primary small cell carcinoma of the esophagus (PSCCE), particularly in cases of limited-stage disease. This retrospective study aimed to assess the treatment strategies and the relevant prognostic factors of limited-stage PSCCE (LS-PSCCE).
Patients and Methods: We retrospectively evaluated 129 patients with LS-PSCCE between June 2009 and December 2018. The χ 2 test was performed to examine the frequencies between different groups. The Kaplan-Meier and log-rank methods were used to estimate and compare survival rates. Univariate and multivariate analyses were performed to determine the prognostic factors for overall survival (OS).
Results: Through a median follow-up of 23 months, the median OS of all patients was 25.0 months and the median recurrence-free survival (RFS) was 15.0 months. Univariate and multivariate analyses showed that alcohol abuse (p=0.046) and TNM stage (p< 0.001) were independent prognostic factors. There was no significant difference in OS and RFS rates between the patients treated with chemoradiotherapy (CRT) and those treated with surgery and chemotherapy with or without radiotherapy (S+CT±RT) (p> 0.05). Patients who received concurrent CRT had better OS and RFS than those who received sequential CRT (p< 0.05). Postoperative adjuvant RT for high-risk patients can further improve the local control rate but has no significant effect on OS.
Conclusion: LS-PSCCE patients treated with CRT had similar OS and RFS compared to those treated with S+CT±RT. This study shows that concurrent CRT confers a survival advantage for patients with LS-PSCCE compared to those with sequential CRT.
Keywords: primary small cell carcinoma of the esophagus, limited-stage, chemoradiotherapy, surgery
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