Induction FOLFOX and PET-Directed Chemoradiation for Locally Advanced Esophageal Adenocarcinoma

被引:5
|
作者
Carr, Rebecca A. [1 ]
Hsu, Meier [2 ]
Harrington, Caitlin A. [1 ]
Tan, Kay See [2 ]
Bains, Manjit S. [1 ]
Bott, Matthew J. [1 ]
Ilson, David H. [3 ]
Isbell, James M. [1 ]
Janjigian, Yelena Y. [3 ]
Maron, Steven B. [3 ]
Park, Bernard J. [1 ]
Rusch, Valerie W. [1 ]
Sihag, Smita [1 ]
Wu, Abraham J. [4 ]
Jones, David R. [1 ]
Ku, Geoffrey Y. [3 ]
Molena, Daniela [1 ]
机构
[1] Mem Sloan Kettering Canc Ctr, Dept Surg, Thorac Serv, 1275 York Ave, New York, NY 10021 USA
[2] Mem Sloan Kettering Canc Ctr, Dept Epidemiol & Biostat, New York, NY 10021 USA
[3] Mem Sloan Kettering Canc Ctr, Dept Med, Gastrointestinal Oncol Serv, 1275 York Ave, New York, NY 10021 USA
[4] Mem Sloan Kettering Canc Ctr, Dept Radiat Oncol, 1275 York Ave, New York, NY 10021 USA
基金
美国国家卫生研究院;
关键词
CROSS regimen; esophageal adenocarcinoma; FOLFOX; induction; positron emission tomography-directed chemoradiation; COMPLETE PATHOLOGICAL RESPONSE; ESOPHAGOGASTRIC JUNCTION; PREOPERATIVE CHEMORADIOTHERAPY; NEOADJUVANT CHEMORADIOTHERAPY; TUMOR-REGRESSION; SURVIVAL; CHEMOTHERAPY; CANCER; CARCINOMA; THERAPY;
D O I
10.1097/SLA.0000000000005163
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective: To compare the efficacy and safety of induction FOLFOX followed by PET-directed nCRT, induction CP followed by PET-directed nCRT, and nCRT with CP alone in patients with EAC. Summary of Background Data: nCRT with CP is a standard treatment for locally advanced EAC. The results of cancer and leukemia group B 80803 support the use of induction chemotherapy followed by PET-directed chemo-radiation therapy. Methods: We retrospectively identified all patients with EAC who underwent the treatments above followed by esophagectomy. We assessed incidences of pathologic complete response (pCR), near-pCR (ypN0 with >= 90% response), and surgical complications between treatment groups using Fisher exact test and logistic regression; disease-free survival (DFS) and overall survival (OS) were estimated by the Kaplan-Meier method and evaluated using the log-rank test and extended Cox regression. Results: In total, 451 patients were included: 309 (69%) received induction chemotherapy before nCRT (FOLFOX, n = 70; CP, n = 239); 142 (31%) received nCRT with CP. Rates of pCR (33% vs. 16%, P = 0.004), near-pCR (57% vs. 33%, P < 0.001), and 2-year DFS (68% vs. 50%, P = 0.01) were higher in the induction FOLFOX group than in the induction CP group. Similarly, the rate of near-pCR (57% vs. 42%, P = 0.04) and 2-year DFS (68% vs. 44%, P < 0.001) were significantly higher in the FOLFOX group than in the no-induction group. Conclusions: Induction FOLFOX followed by PET-directed nCRT may result in better histopathologic response rates and DFS than either induction CP plus PET-directed nCRT or nCRT with CP alone.
引用
收藏
页码:E538 / E544
页数:7
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