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  Table of Contents  
MCQS
Year : 2022  |  Volume : 59  |  Issue : 2  |  Page : 263-264
 

MCQs on “Sequential chemotherapy after definitive radiotherapy in markedly elderly patients with advanced esophageal cancer”


1 Departments of Medical Oncology and Hemato-oncology, Command Hospital Air Force, Bangalore, Karnataka, India
2 Surgical Oncology, Command Hospital Air Force, Bangalore, Karnataka, India
3 Department of Internal Medicine, B. J. Govt. Medical College, Pune, Maharashtra, India

Date of Submission21-Jun-2022
Date of Decision25-Jun-2022
Date of Acceptance20-Jul-2022
Date of Web Publication08-Aug-2022

Correspondence Address:
H S Darling
Departments of Medical Oncology and Hemato-oncology, Command Hospital Air Force, Bangalore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijc.ijc_725_22

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How to cite this article:
Darling H S, Jaiswal P, Tiwari NR. MCQs on “Sequential chemotherapy after definitive radiotherapy in markedly elderly patients with advanced esophageal cancer”. Indian J Cancer 2022;59:263-4

How to cite this URL:
Darling H S, Jaiswal P, Tiwari NR. MCQs on “Sequential chemotherapy after definitive radiotherapy in markedly elderly patients with advanced esophageal cancer”. Indian J Cancer [serial online] 2022 [cited 2022 Sep 28];59:263-4. Available from: https://www.indianjcancer.com/text.asp?2022/59/2/263/353599




Q 1. In the study by Watanabe et al., patients with which of the following stages of esophageal cancer were studied?

  1. Stage IVa and IVb
  2. Stage I and IIa
  3. Stage III and IVa
  4. Stage IIb and IIIa


Q 2. Which of the following is the standard of care for patients with esophageal cancer who are nonsurgical candidates?

  1. Sequential chemoradiation
  2. Concurrent chemoradiation
  3. Chemotherapy alone
  4. Radiotherapy alone


Q 3. In the study by Watanabe et al., which of the following endpoints showed statistically significant improvement in the intervention arm compared to the control arm?

  1. Total progression-free survival (TPFS)
  2. Overall survival (OS)
  3. Progression-free survival out of the radiation field (OFPFS)
  4. All of the above


Q 4. Population showing which of the following characteristics is most suitable for treatment with sequential chemoradiotherapy based on the study conducted by Watanabe et al.?

  1. Elderly (>75 years), nonsurgical candidates
  2. Women, nonsurgical candidates
  3. Women, cancer of lower thoracic esophagus
  4. Women, normal serum albumin


Q 5. How many patients received induction chemotherapy in the study?

  1. 0%
  2. 9%
  3. 16%
  4. 23%


Q 6. The sequential chemotherapy regimen used in majority of patients in the study conducted by Watanabe et al. was

  1. Cisplatin and 5-fluorouracil
  2. Docetaxel and cisplatin
  3. Cisplatin and 5-fluorouracil followed by docetaxel and cisplatin
  4. Docetaxel, cisplatin, and 5-fluorouracil


Q 7. In the study by Watanabe et al., all patients who completed the planned SCRT regimen were

  1. More than 77 years and PS0 at the end of radiotherapy
  2. Less than 77 years and PS1–2 at the end of radiotherapy
  3. More than 77 years and PS1–2 at the end of radiotherapy
  4. Less than 77 years and PS0 at the end of radiotherapy


Q 8. The pathological type of esophageal cancer in patients in the study by Watanabe et al. was

  1. Adenocarcinoma
  2. Squamous cell carcinoma
  3. 13% adenocarcinoma and 87% squamous cell carcinoma
  4. 21% adenocarcinoma and 79% squamous cell carcinoma


Q 9. Find the least correct option.

In elderly patients, the use of chemotherapy is often limited due to

  1. Age-associated decline in functional reserve
  2. Increased rates of comorbid conditions
  3. Concomitant medication use
  4. Poor treatment response


Q 10. Out of 40 patients in the study by Watanabe et al., patients with complete remission, partial remission, and stable disease, respectively, were

  1. 5, 33, and 2
  2. 0, 33, and 7
  3. 5, 13, and 22
  4. 33, 5, and 2


Answers and explanations

1 (c) Stage III and IVa

In the study conducted by Watanabe et al.,[1] patients with advanced esophageal cancer (Stage III and IVa) were included in the study population. The study focused on elderly population (>75 years age), who are less likely to tolerate concurrent chemoradiotherapy.

2 (b) Concurrent chemoradiation

In general, patients with esophageal cancer who are poor surgical candidates due to various reasons (advanced disease, unfit for surgery due to other medical comorbidities, etc.) are treated with concurrent chemoradiotherapy.[2]

3 (d) All of the above

In the study conducted by Watanabe et al.,[1] the patient with advanced esophageal cancer treated with sequential radiotherapy (treatment arm) had significant TPFS, OS, and OFPFS benefit compared to the patient who received radiotherapy alone as a treatment modality (control arm).

4 (a) Elderly (>75 years), nonsurgical candidates

The study done by Watanabe et al. focused predominantly on the elderly patients (>75 years), who have advanced esophageal cancer (Stage III and IVa). The study did show significant survival benefit (TPFS, OS, OFPFS) in elderly patients treated with sequential chemoradiotherapy compared to treatment with radiotherapy alone. No significant benefits were observed in univariate analyses comparing sex, serum albumin level, and body mass index (BMI).

5 (a) 0%

No patients received induction chemotherapy.[1]

6 (c) Cisplatin and 5-fluorouracil followed by docetaxel and cisplatin

The standard sequential chemotherapy regimen was of two courses of standard-dose cisplatin and 5-fluorouracil followed by three courses of docetaxel and cisplatin.[1]

7 (d) Less than 77 years and PS0 at the end of radiotherapy

In the present study, all patients who completed the planned SCRT regimen were under 77 and PS0 at the end of radiotherapy. This criterion may be a selection criterion to choose patients for SCRT.[1]

8 (b) Squamous cell carcinoma

The pathological type was squamous cell carcinoma in all patients.[1]

9 (d) Poor treatment response

In elderly patients, the use of chemotherapy is often limited due to age-associated decline in functional reserve, increased rates of comorbid conditions, and concomitant medication use.[1]

10 (a) 5, 33, and 2

The therapeutic effects at the end of radiotherapy were complete remission, partial remission, and stable disease in 5, 33, and 2 patients, respectively.[1]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Watanabe S, Ogino I, Kunisaki C, Hata M. Sequential chemotherapy after definitive radiotherapy in markedly elderly patients with advanced esophageal cancer. Indian J Cancer 2022;59:244-50. doi: 10.4103/ijc.IJC_768_19.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Ajani JA, D'Amico TA, Bentrem DJ, Chao J, Corvera C, Das P, et al. Esophageal and esophagogastric junction cancers, version 2.2019, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 2019;17:855-83.  Back to cited text no. 2
    




 

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