Neoadjuvant versus definitive chemoradiotherapy for locally advanced esophageal cancer Outcomes and patterns of failure

被引:0
|
作者
Haefner, Matthias Felix [1 ,2 ]
Lang, Kristin [1 ,2 ]
Verma, Vivek [3 ]
Koerber, Stefan Alexander [1 ,2 ]
Uhlmann, Lorenz [4 ]
Debus, Juergen [1 ,2 ]
Sterzing, Florian [2 ,5 ]
机构
[1] Univ Hosp Heidelberg, Dept Radiat Oncol, Neuenheimer Feld 400, D-69120 Heidelberg, Germany
[2] Natl Ctr Radiat Res Oncol NCRO, HIRO, Neuenheimer Feld 400, D-69120 Heidelberg, Germany
[3] Univ Nebraska Med Ctr, Dept Radiat Oncol, Omaha, NE USA
[4] Heidelberg Univ, IMBI, Neuenheimer Feld 130-3, D-69120 Heidelberg, Germany
[5] Hosp Kempten, Dept Radiat Oncol, Robert Weixler Str 50, D-87439 Kempten, Germany
关键词
Neoplasm recurrence; local; Esophagectomy; Toxicity; Survival; Treatment failure; PHASE-III TRIAL; CHEMORADIATION; SURGERY; THERAPY; RADIOTHERAPY; CHEMOTHERAPY; METAANALYSIS; STRATEGIES; MANAGEMENT; CARCINOMA;
D O I
10.1007/s00066-017-1211-0
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Randomized trials examining neoadjuvant chemoradiotherapy followed by surgical resection (nCRT-S) and definitive CRT (dCRT) for esophageal cancer (EC) patients are hampered by use of nonstandard treatment paradigms. Outcomes of nCRT-S versus dCRT in a more common patient population are lacking. We investigated local control and survival, evaluated clinical factors associated with endpoints, and assessed patterns of failure between these cohorts. We retrospectively analyzed 130 patients with locally advanced EC receiving either dCRT or nCRT-S at our institution from 2000-2012. Inclusion criteria were curatively treated nonmetastatic EC, Karnofsky performance status ae<yen>70%, and receipt of concomitant CRT. Patients were excluded if receiving < 41 Gy neoadjuvantly or < 50 Gy definitively. Kaplan-Meier analysis was used to evaluate local recurrence (LR), progression-free survival (PFS), and overall survival (OS). Univariate and multivariate Cox proportional hazards modeling addressed factors associated with outcomes. Patterns of failure were enumerated as local, regional, or distant. Mean follow-up was 34.2 months. The 3aEuroyear LR was 10.8% in the nCRT-S group and 21.5% in the dCRT group (p = 0.266). Median PFS were 15.6 and 14.9 months, respectively (p = 0.549). Median OS were 20.6 and 25.9 months, respectively (p = 0.81). On univariate and multivariate analysis, none of the investigated factors was associated with outcomes, although node-positive disease showed a trend for worse OS and PFS. Most common failures in both groups were distant (dCRT 31.2% vs. nCRT-S 21.6%) followed by local in-field recurrences (dCRT 26.9% vs. nCRT-S 10.8%). In this institutional analysis, no significant differences regarding outcomes and patterns of failure were observed between nCRT-S and dCRT.
引用
收藏
页码:116 / 124
页数:9
相关论文
共 50 条
  • [41] A Comparison of Clinicopathologic Outcomes and Patterns of Lymphatic Spread Across Neoadjuvant Chemotherapy, Neoadjuvant Chemoradiotherapy, and Neoadjuvant Immunochemotherapy in Locally Advanced Esophageal Squamous Cell Carcinoma
    Yuanyuan Tian
    Zhenguo Shi
    Chenyu Wang
    Shaobo Ke
    Hu Qiu
    Wensi Zhao
    Yong Wu
    Jiamei Chen
    Yaowen Zhang
    Yongshun Chen
    Annals of Surgical Oncology, 2024, 31 : 860 - 871
  • [42] A Comparison of Clinicopathologic Outcomes and Patterns of Lymphatic Spread Across Neoadjuvant Chemotherapy, Neoadjuvant Chemoradiotherapy, and Neoadjuvant Immunochemotherapy in Locally Advanced Esophageal Squamous Cell Carcinoma
    Tian, Yuanyuan
    Shi, Zhenguo
    Wang, Chenyu
    Ke, Shaobo
    Qiu, Hu
    Zhao, Wensi
    Wu, Yong
    Chen, Jiamei
    Zhang, Yaowen
    Chen, Yongshun
    ANNALS OF SURGICAL ONCOLOGY, 2024, 31 (01) : 28 - 30
  • [43] Definitive concurrent chemoradiotherapy in locally advanced pancreatic cancer
    Kwak, Yoo-Kang
    Lee, Jong Hoon
    Lee, Myung-Ah
    Chun, Hoo-Geun
    Kim, Dong-Goo
    You, Young Kyoung
    Hong, Tae-Ho
    Jang, Hong Seok
    RADIATION ONCOLOGY JOURNAL, 2014, 32 (02): : 49 - 56
  • [44] Predicting the patterns of response to neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer
    Martinez, C. Graham
    Rombouts, A.
    Bosch, S.
    van de Water, C.
    Vierrijp, K.
    de Wilt, H.
    Simmer, F.
    Nagtegaal, I.
    VIRCHOWS ARCHIV, 2020, 477 : S184 - S185
  • [45] Locally Advanced Pancreatic Cancer: The Role of Definitive Chemoradiotherapy
    Huguet, F.
    Mukherjee, S.
    Javle, M.
    CLINICAL ONCOLOGY, 2014, 26 (09) : 560 - 568
  • [46] Impact of histology on patterns of failure and clinical outcomes in patients treated with definitive chemoradiotherapy for locally advanced non-small cell lung cancer
    Ito, Hitoshi
    Matsuo, Yukinori
    Ohtsu, Shuji
    Nishimura, Takashi
    Terada, Yasuji
    Sakamoto, Takashi
    Mizowaki, Takashi
    INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY, 2020, 25 (02) : 274 - 281
  • [47] Impact of histology on patterns of failure and clinical outcomes in patients treated with definitive chemoradiotherapy for locally advanced non-small cell lung cancer
    Hitoshi Ito
    Yukinori Matsuo
    Shuji Ohtsu
    Takashi Nishimura
    Yasuji Terada
    Takashi Sakamoto
    Takashi Mizowaki
    International Journal of Clinical Oncology, 2020, 25 : 274 - 281
  • [48] Neoadjuvant chemotherapy combined with immunotherapy versus neoadjuvant chemoradiotherapy in patients with locally advanced esophageal squamous cell carcinoma
    Yu, Yong-kui
    Meng, Fan-Yu
    Wei, Xiu-feng
    Chen, Xian-kai
    Li, Hao-miao
    Liu, Qi
    Li, Can-jun
    Xie, Hou-nai
    Xu, Lei
    Zhang, Rui-xiang
    Xing, Wenqun
    Li, Yin
    JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2024, 168 (02):
  • [49] Comparison of Definitive Chemoradiotherapy in Locally Advanced Esophageal Squamous Cell Carcinoma
    Yao, Bin
    Tan, Bingxu
    Wang, Cong
    Song, Qingxu
    Wang, Jianbo
    Guan, Shanghai
    Jia, Yibin
    Ma, Yanan
    Huang, Xiaochen
    Sun, Yi
    Cheng, Yufeng
    ANNALS OF SURGICAL ONCOLOGY, 2016, 23 (07) : 2367 - 2372
  • [50] Meta-analysis of neoadjuvant chemotherapy versus neoadjuvant chemoradiotherapy for locally advanced rectal cancer
    Huaqin Lin
    Lei Wang
    Xiaohong Zhong
    Xueqing Zhang
    Lingdong Shao
    Junxin Wu
    World Journal of Surgical Oncology, 19