Multimodality therapy is recommended for limited-stage combined small cell esophageal carcinoma

Huan Huan Wang, Nicholas G. Zaorsky, Mao Bin Meng, Zhi Qiang Wu, Xian Liang Zeng, Bo Jiang, Chao Jiang, Lu Jun Zhao, Zhi Yong Yuan, Ping Wang

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background and aim: Limited-stage combined small cell esophageal carcinoma (LS-C-SCEC) is a rare, poorly understood, underdiagnosed disease, with components of both small cell esophageal cancer and non–small cell esophageal cancer. We investigated the optimal treatment strategy and prognostic factors in patients with LS-C-SCEC. Patients and methods: LS-C-SCEC patients included in the analysis (from our hospital and the literature) were treated between January 1966 and December 2013. Patient treatment strategies included surgery (S), chemotherapy (CT), and radiation therapy (RT). The primary end point was overall survival (OS); the secondary end points included tumor complete response rates, patterns of failure, and toxicity. Kaplan–Meier curves were compared with the log-rank test. Univariate and multivariate analyses were used to determine prognosticators for OS. Results: A total of 72 patients were included in the analysis: 24 (33%) from our hospital and 48 (67%) from the literature. The median OS of all patients was 15.0 months. Patients who received CT had a significantly longer median OS than did those who did not (OS 22.8 months vs 10.0 months) (P=0.03). Patients treated with multimodality therapy (including RT+CT [18%], S+CT [40%], or S+RT+CT [17%]) vs monotherapy (typically, S [18%]) had significantly improved OS (15.5 months vs 9.3 months) (P=0.02) and complete response rates. On multivariate analysis, tumor location (upper third of the esophagus) and type of treatment (monotherapy) were the only factors predictive of poor OS. Conclusion: Multimodality therapy (including RT+CT, S+CT, or S+RT+CT) improves OS for patients with LS-C-SCEC compared with monotherapy (typically, S). Additional studies are necessary to personalize multimodal treatment approaches to individual patients.

Original languageEnglish (US)
Pages (from-to)437-444
Number of pages8
JournalOncoTargets and Therapy
Volume8
DOIs
StatePublished - Feb 13 2015

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Small Cell Carcinoma
Drug Therapy
Survival
Radiotherapy
Therapeutics
Esophageal Neoplasms
Multivariate Analysis
Combined Modality Therapy
Esophagus
Neoplasms

All Science Journal Classification (ASJC) codes

  • Oncology
  • Pharmacology (medical)

Cite this

Wang, Huan Huan ; Zaorsky, Nicholas G. ; Meng, Mao Bin ; Wu, Zhi Qiang ; Zeng, Xian Liang ; Jiang, Bo ; Jiang, Chao ; Zhao, Lu Jun ; Yuan, Zhi Yong ; Wang, Ping. / Multimodality therapy is recommended for limited-stage combined small cell esophageal carcinoma. In: OncoTargets and Therapy. 2015 ; Vol. 8. pp. 437-444.
@article{251ecf8147314d258c32e3b604ed4643,
title = "Multimodality therapy is recommended for limited-stage combined small cell esophageal carcinoma",
abstract = "Background and aim: Limited-stage combined small cell esophageal carcinoma (LS-C-SCEC) is a rare, poorly understood, underdiagnosed disease, with components of both small cell esophageal cancer and non–small cell esophageal cancer. We investigated the optimal treatment strategy and prognostic factors in patients with LS-C-SCEC. Patients and methods: LS-C-SCEC patients included in the analysis (from our hospital and the literature) were treated between January 1966 and December 2013. Patient treatment strategies included surgery (S), chemotherapy (CT), and radiation therapy (RT). The primary end point was overall survival (OS); the secondary end points included tumor complete response rates, patterns of failure, and toxicity. Kaplan–Meier curves were compared with the log-rank test. Univariate and multivariate analyses were used to determine prognosticators for OS. Results: A total of 72 patients were included in the analysis: 24 (33{\%}) from our hospital and 48 (67{\%}) from the literature. The median OS of all patients was 15.0 months. Patients who received CT had a significantly longer median OS than did those who did not (OS 22.8 months vs 10.0 months) (P=0.03). Patients treated with multimodality therapy (including RT+CT [18{\%}], S+CT [40{\%}], or S+RT+CT [17{\%}]) vs monotherapy (typically, S [18{\%}]) had significantly improved OS (15.5 months vs 9.3 months) (P=0.02) and complete response rates. On multivariate analysis, tumor location (upper third of the esophagus) and type of treatment (monotherapy) were the only factors predictive of poor OS. Conclusion: Multimodality therapy (including RT+CT, S+CT, or S+RT+CT) improves OS for patients with LS-C-SCEC compared with monotherapy (typically, S). Additional studies are necessary to personalize multimodal treatment approaches to individual patients.",
author = "Wang, {Huan Huan} and Zaorsky, {Nicholas G.} and Meng, {Mao Bin} and Wu, {Zhi Qiang} and Zeng, {Xian Liang} and Bo Jiang and Chao Jiang and Zhao, {Lu Jun} and Yuan, {Zhi Yong} and Ping Wang",
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Wang, HH, Zaorsky, NG, Meng, MB, Wu, ZQ, Zeng, XL, Jiang, B, Jiang, C, Zhao, LJ, Yuan, ZY & Wang, P 2015, 'Multimodality therapy is recommended for limited-stage combined small cell esophageal carcinoma', OncoTargets and Therapy, vol. 8, pp. 437-444. https://doi.org/10.2147/OTT.S76048

Multimodality therapy is recommended for limited-stage combined small cell esophageal carcinoma. / Wang, Huan Huan; Zaorsky, Nicholas G.; Meng, Mao Bin; Wu, Zhi Qiang; Zeng, Xian Liang; Jiang, Bo; Jiang, Chao; Zhao, Lu Jun; Yuan, Zhi Yong; Wang, Ping.

In: OncoTargets and Therapy, Vol. 8, 13.02.2015, p. 437-444.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Multimodality therapy is recommended for limited-stage combined small cell esophageal carcinoma

AU - Wang, Huan Huan

AU - Zaorsky, Nicholas G.

AU - Meng, Mao Bin

AU - Wu, Zhi Qiang

AU - Zeng, Xian Liang

AU - Jiang, Bo

AU - Jiang, Chao

AU - Zhao, Lu Jun

AU - Yuan, Zhi Yong

AU - Wang, Ping

PY - 2015/2/13

Y1 - 2015/2/13

N2 - Background and aim: Limited-stage combined small cell esophageal carcinoma (LS-C-SCEC) is a rare, poorly understood, underdiagnosed disease, with components of both small cell esophageal cancer and non–small cell esophageal cancer. We investigated the optimal treatment strategy and prognostic factors in patients with LS-C-SCEC. Patients and methods: LS-C-SCEC patients included in the analysis (from our hospital and the literature) were treated between January 1966 and December 2013. Patient treatment strategies included surgery (S), chemotherapy (CT), and radiation therapy (RT). The primary end point was overall survival (OS); the secondary end points included tumor complete response rates, patterns of failure, and toxicity. Kaplan–Meier curves were compared with the log-rank test. Univariate and multivariate analyses were used to determine prognosticators for OS. Results: A total of 72 patients were included in the analysis: 24 (33%) from our hospital and 48 (67%) from the literature. The median OS of all patients was 15.0 months. Patients who received CT had a significantly longer median OS than did those who did not (OS 22.8 months vs 10.0 months) (P=0.03). Patients treated with multimodality therapy (including RT+CT [18%], S+CT [40%], or S+RT+CT [17%]) vs monotherapy (typically, S [18%]) had significantly improved OS (15.5 months vs 9.3 months) (P=0.02) and complete response rates. On multivariate analysis, tumor location (upper third of the esophagus) and type of treatment (monotherapy) were the only factors predictive of poor OS. Conclusion: Multimodality therapy (including RT+CT, S+CT, or S+RT+CT) improves OS for patients with LS-C-SCEC compared with monotherapy (typically, S). Additional studies are necessary to personalize multimodal treatment approaches to individual patients.

AB - Background and aim: Limited-stage combined small cell esophageal carcinoma (LS-C-SCEC) is a rare, poorly understood, underdiagnosed disease, with components of both small cell esophageal cancer and non–small cell esophageal cancer. We investigated the optimal treatment strategy and prognostic factors in patients with LS-C-SCEC. Patients and methods: LS-C-SCEC patients included in the analysis (from our hospital and the literature) were treated between January 1966 and December 2013. Patient treatment strategies included surgery (S), chemotherapy (CT), and radiation therapy (RT). The primary end point was overall survival (OS); the secondary end points included tumor complete response rates, patterns of failure, and toxicity. Kaplan–Meier curves were compared with the log-rank test. Univariate and multivariate analyses were used to determine prognosticators for OS. Results: A total of 72 patients were included in the analysis: 24 (33%) from our hospital and 48 (67%) from the literature. The median OS of all patients was 15.0 months. Patients who received CT had a significantly longer median OS than did those who did not (OS 22.8 months vs 10.0 months) (P=0.03). Patients treated with multimodality therapy (including RT+CT [18%], S+CT [40%], or S+RT+CT [17%]) vs monotherapy (typically, S [18%]) had significantly improved OS (15.5 months vs 9.3 months) (P=0.02) and complete response rates. On multivariate analysis, tumor location (upper third of the esophagus) and type of treatment (monotherapy) were the only factors predictive of poor OS. Conclusion: Multimodality therapy (including RT+CT, S+CT, or S+RT+CT) improves OS for patients with LS-C-SCEC compared with monotherapy (typically, S). Additional studies are necessary to personalize multimodal treatment approaches to individual patients.

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