Post-operative Radiotherapy for Esophageal Cancer

Post-operative Radiotherapy for Esophageal Cancer Parag Sanghvi, M.D., M.S.P.H. Department of Radiation Medicine Esophageal Care Conference

Preoperative ChemoRT vs. Post-operative ChemoRT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Post-operative RT+/- Chemotherapy ,[object Object],[object Object],[object Object]

Indications for Post-operative RT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Current NCCN Guidelines for Post-operative Therapy

Randomized Trials ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

French trial – Post-operative Radiation for Esophageal SCCA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Hong Kong Trial – Postoperative RT for Esophageal cancer ,[object Object],[object Object],[object Object],[object Object]

Hong Kong Trial - Results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Chinese trial – Post-operative radiation for Esophageal SCCA ,[object Object],[object Object],[object Object]

Chinese Trial – RT parameters ,[object Object],[object Object],[object Object],[object Object]

Chinese Trial - Results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Chinese trial - Results Stage III

Chinese trial - Results LN + patients

Chinese Trial - Sites of Failure

Conclusions ,[object Object],[object Object]

Macdonald trial – Post-operative chemoRT for GE junction/stomach adenoCA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Macdonald Trial - Treatment Schema ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Macdonald Trial – Tumor Characteristics

Macdonald Trial Results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Macdonald Trial – Overall Survival

Macdonald Trial – Relapse Free Survival

Macdonald Trial – Sites of Relapse

Macdonald Trial - Conclusions ,[object Object],[object Object],[object Object],[object Object],[object Object]

Non Randomized Trials ,[object Object],[object Object],[object Object],[object Object]

Taiwan Study – Postoperative ChemoRT vs. RT for esophageal SCCA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Taiwan study – RT parameters ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Taiwan study - Chemotherapy ,[object Object],[object Object],[object Object]

Taiwan study - Patient Characteristics

Taiwan Study - Results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Taiwan Study - Results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Taiwan Study - ChemoRT complications ,[object Object],[object Object],[object Object],[object Object]

Taiwan Study - Conclusions ,[object Object],[object Object]

Canadian Study – Postoperative chemoRT in patients with N+ esophageal cancer ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Canadian Study - Treatment Schema ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Canadian Study - Patient Characteristics ,[object Object],[object Object]

Canadian Study –Tumor Characteristics

Canadian Study - Results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Canadian Study – Overall Survival

Canadian Trial - Conclusion ,[object Object]

Additional abstracts ,[object Object],[object Object],[object Object],[object Object],[object Object]

Additional abstracts ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

What about post-op chemotherapy alone? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Overall Conclusions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Acknowledgements ,[object Object],[object Object],[object Object]

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