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?
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · University of North Carolina at Chapel Hill
Answered on
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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Mednet MemberInvited Expert
Radiation Oncology · Memorial Sloan Kettering Cancer Center
Answered on · Updated on
I agree with @Dr. First Last'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...
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