File Download
  Links for fulltext
     (May Require Subscription)
  • Find via Find It@HKUL

Conference Paper: COX-2 inhibition in combination with pre-operative chemoradiation for CA esophagus

TitleCOX-2 inhibition in combination with pre-operative chemoradiation for CA esophagus
Authors
Issue Date2009
PublisherAmerican Society of Clinical Oncology. The Journal's web site is located at http://www.jco.org/
Citation
The 45th Annual Meeting of the American Society of Clinical Oncology (ASCO 2009), Orlando, FL., 29 May-2 June 2009. In Journal of Clinical Oncology, 2009, v. 27 suppl. abstract no. e15607 How to Cite?
AbstractBACKGROUND: Squamous cell carcinoma of the thoracic esophagus (ESCC) is often diagnosed in advanced stage. Pre-operative chemoradiation is employed to downstage the disease before operation. Pathological complete response (pCR) was observed in around 20-40% of patients and was associated with improved survival. Cyclooxygenase 2 (COX-2) is overexpressed in ESCC and may contribute to chemo- and radio-resistance. This pilot study evaluates if COX-2 inhibition in combination with pre-operative chemoradiation will improve the response rate in ESCC. METHODS: Patients with histologically confirmed ESCC undergo endoscopic ultrasound, ultrasound of neck and PET/ thoracic, abdominal CT for staging. Patients with disease which is considered potentially resectable are eligible. The primary and involved lymph nodes are irradiated to 40Gy in 20 fractions over 4 weeks with 2 cycles of concurrent cisplatin (100mg/sqm, D1, D22) and 5 fluorouracil (500mg/sqm, D1-5, D22-26). Celecoxib, a specific COX-2 inhibitor, 400mg bid, is started for 2 weeks before chemoradiation, continued throughout chemoradiation and for 4 more weeks after completion of chemoradiation. Patients are re-evaluated and esophagectomy is performed 6-8 weeks after completion of chemoradiation. RESULTS: From 2004 to 2008, 32 patients were recruited. Pre-operative staging was stage II in 4, stage III in 25 and stage IVA in 3 patients. Celecoxib was well tolerated. 3 patients did not have full course of celecoxib: 1 complained of epigastric pain, 1 died early of disease, 1 had renal impairment after chemotherapy. 29 patients had esophagectomy performed after chemoradiation. Median follow-up after completion of chemoradiation was 11 months (range: 3 to 43 months). 23 patients (79.3%) had downstaging of the primary compared with pre-operative staging. The pCR rate in primary tumor was 51.7% (15/29 patients) and pCR rate in lymph nodes was 65.4% (17/26 patients). 3 years overall survival of patients who had esophagectomy was 79.3%. CONCLUSIONS: COX-2 inhibition in combination with pre-operative chemoradiation is well tolerated. Preliminary results of the pCR rates and survival are encouraging. Incorporation of COX-2 inhibition into multi-modality treatment of ESCC should be further investigated in a randomized trial.
DescriptionThis abstract will not be presented at the 2009 ASCO Annual Meeting but has been published in conjunction with the meeting
Persistent Identifierhttp://hdl.handle.net/10722/62703
ISSN
2015 Impact Factor: 20.982
2015 SCImago Journal Rankings: 9.204

 

DC FieldValueLanguage
dc.contributor.authorKwong, DLen_HK
dc.contributor.authorLaw, SY-
dc.contributor.authorTong, DKH-
dc.contributor.authorNicholls, J-
dc.date.accessioned2010-07-13T04:07:21Z-
dc.date.available2010-07-13T04:07:21Z-
dc.date.issued2009en_HK
dc.identifier.citationThe 45th Annual Meeting of the American Society of Clinical Oncology (ASCO 2009), Orlando, FL., 29 May-2 June 2009. In Journal of Clinical Oncology, 2009, v. 27 suppl. abstract no. e15607-
dc.identifier.issn0732-183X-
dc.identifier.urihttp://hdl.handle.net/10722/62703-
dc.descriptionThis abstract will not be presented at the 2009 ASCO Annual Meeting but has been published in conjunction with the meetingen_HK
dc.description.abstractBACKGROUND: Squamous cell carcinoma of the thoracic esophagus (ESCC) is often diagnosed in advanced stage. Pre-operative chemoradiation is employed to downstage the disease before operation. Pathological complete response (pCR) was observed in around 20-40% of patients and was associated with improved survival. Cyclooxygenase 2 (COX-2) is overexpressed in ESCC and may contribute to chemo- and radio-resistance. This pilot study evaluates if COX-2 inhibition in combination with pre-operative chemoradiation will improve the response rate in ESCC. METHODS: Patients with histologically confirmed ESCC undergo endoscopic ultrasound, ultrasound of neck and PET/ thoracic, abdominal CT for staging. Patients with disease which is considered potentially resectable are eligible. The primary and involved lymph nodes are irradiated to 40Gy in 20 fractions over 4 weeks with 2 cycles of concurrent cisplatin (100mg/sqm, D1, D22) and 5 fluorouracil (500mg/sqm, D1-5, D22-26). Celecoxib, a specific COX-2 inhibitor, 400mg bid, is started for 2 weeks before chemoradiation, continued throughout chemoradiation and for 4 more weeks after completion of chemoradiation. Patients are re-evaluated and esophagectomy is performed 6-8 weeks after completion of chemoradiation. RESULTS: From 2004 to 2008, 32 patients were recruited. Pre-operative staging was stage II in 4, stage III in 25 and stage IVA in 3 patients. Celecoxib was well tolerated. 3 patients did not have full course of celecoxib: 1 complained of epigastric pain, 1 died early of disease, 1 had renal impairment after chemotherapy. 29 patients had esophagectomy performed after chemoradiation. Median follow-up after completion of chemoradiation was 11 months (range: 3 to 43 months). 23 patients (79.3%) had downstaging of the primary compared with pre-operative staging. The pCR rate in primary tumor was 51.7% (15/29 patients) and pCR rate in lymph nodes was 65.4% (17/26 patients). 3 years overall survival of patients who had esophagectomy was 79.3%. CONCLUSIONS: COX-2 inhibition in combination with pre-operative chemoradiation is well tolerated. Preliminary results of the pCR rates and survival are encouraging. Incorporation of COX-2 inhibition into multi-modality treatment of ESCC should be further investigated in a randomized trial.-
dc.languageengen_HK
dc.publisherAmerican Society of Clinical Oncology. The Journal's web site is located at http://www.jco.org/-
dc.relation.ispartofJournal of Clinical Oncology-
dc.titleCOX-2 inhibition in combination with pre-operative chemoradiation for CA esophagusen_HK
dc.typeConference_Paperen_HK
dc.identifier.emailKwong, DL: dlwkwong@hku.hken_HK
dc.identifier.emailLaw, SY: slaw@hku.hk-
dc.identifier.emailTong, DKH: esodtong@hku.hk-
dc.identifier.emailNicholls, J: jmnichol@hkucc.hku.hk-
dc.identifier.authorityKwong, DL=rp00414en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.hkuros166451en_HK
dc.identifier.volume27-
dc.identifier.issuesuppl.-
dc.publisher.placeUnited States-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats