Induction chemotherapy followed by chemoradiation in locally advanced XXXX : an effective and well-tolerated treatment.

@entity1 @entity788 @entity137 @entity5 @entity204 @entity136
AIMS: The treatment of locally advanced @entity788 varies enormously both within the UK and internationally. Although chemoradiation is the treatment of choice in the USA, in the UK this modality is used infrequently because of concerns regarding both its efficacy and its @entity137 . We reviewed our experience with induction chemotherapy and selective chemoradiation in an attempt to show that it is a well-tolerated treatment that may be superior to chemotherapy alone. MATERIALS AND METHODS: Case notes of @entity1 with locally advanced @entity788 referred to the @entity5 Centre between 1 March 2005 and 31 October 2007 were reviewed. Data on @entity1 demographics, @entity5 characteristics, treatment and overall survival were collected retrospectively. @entity137 data during chemoradiation were collected prospectively. @entity1 who had non-progressive disease after 3 months of chemotherapy were planned for chemoradiation using three-dimensional conformal radiotherapy to a total dose of 4500-5040cGy in 25-28 daily fractions with @entity136 as a radiosensitiser. RESULTS: Of the 91 referrals, 69 (76%) were fit for active oncological treatment; 43/69 (62%) @entity1 were considered for induction chemotherapy followed by chemoradiation and 16/43 (37%) @entity1 received chemoradiation. The median overall survival for @entity1 receiving primary chemotherapy (n=26) was 9.2 (6.8-11.9) months and was 15.3 (11.6-upper limit not reached) months for @entity1 who received chemoradiation (n=16). During the induction chemotherapy 8/16 (50%) @entity1 experienced grade 3/4 @entity137 and there were five hospital admissions. During chemoradiation there were 6/16 (37.5%) cases of grade 3/4 @entity137 and two hospital admissions. There were no treatment-related @entity204 . Overall, 94.5% of the intended radiotherapy dose and 84% of the concurrent chemotherapy dose was delivered. CONCLUSIONS: In this UK network, about half of @entity1 were considered for chemoradiation, but only 18% received it. Survival and treatment-related @entity137 are consistent with data from other chemoradiation trials and in our series chemoradiation was tolerated better than chemotherapy alone. This supports the view that 'consolidation' chemoradiation is a viable treatment option that should be considered in selected @entity1 with locally advanced non-metastatic @entity788 .
