Esophageal SCC: chemoradiation most common US treatment

  • Verma V & al.
  • Cancer Med
  • 06/11/2018

  • Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • The majority of patients with nonmetastatic esophageal small cell carcinoma (ESCC) are treated with chemoradiotherapy (CRT), according to the largest study to date on the rare cancer.
  • Compared with chemotherapy alone, adding surgery or radiotherapy was associated with better OS.

Why this matters

  • National guidelines offer no consensus on the optimal treatment regimen for ESCC, and research on the best therapy has yielded conflicting results.

Study design

  • 323 patients with newly diagnosed, nonmetastatic ESCC from the National Cancer Database.
  • Funding: None disclosed.

Key results

  • 20% underwent surgical-based treatment, 65% CRT, and 15% chemotherapy alone.
  • No difference in OS between the surgery-based and CRT groups, but both had better OS than chemotherapy alone (P<.001>
  • Median OS for the surgery-based group was 21 (95% CI, 16-33) months vs 18 (95% CI, 15-23) months for CRT, and 10 (95% CI, 6-12) months for chemotherapy alone.
  • After multivariable analysis, receipt of additional local therapy (surgery or radiotherapy) was an independent predictor of better OS (P<.001 and older age increasing t n classification treatment at a community facility residence in an area with lower educational status were all independently associated poorer os for>

Limitations

  • Retrospective study.