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Radiation Oncology • Gastrointestinal Cancers
Should inoperable squamous cell carcinoma of the esophagus be treated to doses > 60 Gy?
Should the recent publication of Chen et al., PMID 27207358 dose escalation study for inoperable SCC esophageal cancer patients treated with CCRT, showing an 8% 5-year OS benefit for high-dose RT (>=60 Gy) versus standard dose (50-50.4 Gy) change current real-world practice for carefully selected patients? Or should we adhere to 50-50.4 Gy until RCT results from prospective trials become available?
Answer from: Radiation Oncologist at Academic Institution
The article mentioned does not, in my opinion, provide sufficient evidence to justify a change in clinical practice. As a general rule, I think we should be extremely careful about using data from retrospective data reviews, such as this review or the commonly used NCDB database, to assert that one ...
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Answer from: Radiation Oncologist at Academic Institution
I agree with @Joel E. Tepper's answer above. I'd also add that a randomized trial of 50 Gy vs. 60 Gy chemoRT for esophageal SCC has recently been reported in abstract form and did not show any benefit to dose escalation. It has generally been our practice at MSKCC to boost SCC above 50.4 Gy if no su...
Comments
Radiation Oncologist at Mon Health
Are there any updates to the above recommendation,...
Are there any updates to the above recommendation,...
Radiation Oncologist at Sutter Medcl Center
The ARTDECO trial randomized medically inoperable ...
The ARTDECO trial randomized medically inoperable ...
Radiation Oncologist at The Toledo Clinic
Thank you for the update, Dr. @Pan.
Thank you for the update, Dr. @Pan.
Radiation Oncologist at Dartmouth-Hitchcock
FYI, the Xu et al. manuscript was published: Xu et...
FYI, the Xu et al. manuscript was published: Xu et...