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Stricture rate after chemoradiotherapy and radiotherapy for oesophageal squamous cell carcinoma: a 20‐year experience
Author(s) -
Hamer Peter W.,
Hight Stephanie C.,
Ward Ian G.,
Harris Dean L.,
Woodham Benjamin L.,
Flint Richard S.
Publication year - 2019
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.14981
Subject(s) - medicine , radiation therapy , chemoradiotherapy , external beam radiotherapy , stage (stratigraphy) , surgery , brachytherapy , paleontology , biology
Background Definitive chemoradiation for oesophageal squamous cell carcinoma (SCC) is the first‐line treatment in many centres. However, it is not without morbidity. We assess outcomes for patients treated with definitive chemoradiotherapy and radiotherapy. Methods A retrospective review of a prospectively maintained database (Radiotherapy Department, Canterbury District Health Board) was undertaken. All patients who underwent definitive radiotherapy for oesophageal SCC between October 1996 and April 2015 were included. Results Sixty patients underwent chemoradiotherapy with curative intent and 17 underwent definitive radiotherapy with curative intent. Median age was 69 years (44–84 years) for those undergoing chemoradiotherapy and 73 years (36–85 years) for those who underwent definitive radiotherapy. Tumour location in all patients was upper third in 14 (18%), middle third in 39 (51%), lower third in 22 (29%) cases and junctional tumour in two (3%). Staging information was complete for 73 of 77 patients (stage I 16/77 (21%), stage II 40/77 (52%), stage III 17/77 (22%)). Median dose of external beam radiotherapy for those who underwent definitive chemotherapy was 50.4 Gy (30–63 Gy) and 60 Gy (50–64 Gy) for definitive radiotherapy. Median length of follow‐up was 39 months (range 4–120 months). Strictures developed in 58% of all patients (52% chemoradiotherapy and 76% definitive radiotherapy). Twenty‐four (32%) patients were dilated and 14 (18%) stented. The chemoradiotherapy group had higher 5‐year survival than definitive radiotherapy group (34% versus 6%, P = 0.0034). Conclusion Oesophageal SCC treated with chemoradiation has a 5‐year survival rate of 34%. Post‐treatment strictures occur in 52% of patients with chemoradiotherapy and 76% with definitive radiotherapy.