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Is concurrent radiation therapy required in patients receiving preoperative chemotherapy for adenocarcinoma of the oesophagus? A randomised phase II trial
- Source :
-
European Journal of Cancer . Feb2011, Vol. 47 Issue 3, p354-360. 7p. - Publication Year :
- 2011
-
Abstract
- Abstract: Introduction: Preoperative chemotherapy (CT) and preoperative chemoradiation therapy (CRT) for resectable oesophageal cancer have been shown to improve overall survival in meta-analyses. There are limited data comparing these preoperative therapies. We report the outcomes of a randomised phase II trial comparing preoperative CT and CRT for resectable adenocarcinoma of the oesophagus and gastro-oesophageal junction. Methods: Patients were randomised to receive preoperative CT with cisplatin (80mg/m2) and infusional 5 fluorouracil (1000mg/m2/d) on days 1 and 21, or preoperative CRT with the same drugs accompanied by concurrent radiation therapy commencing on day 21 of chemotherapy and the 5 fluorouracil reduced to 800mg/m2/d. The radiation dose was 35Gy in 15 fractions over 3weeks. The endpoints were toxicity, response rates, resection (R) status, progression-free survival (PFS), overall survival (OS) and quality of life. Results: Seventy-five patients were enroled on the study: 36 received preoperative CT and 39 preoperative CRT. Toxicity was similar for CT and CRT. Eight patients (11%) did not proceed to resection. The histopathological response rate (CRT 31% versus CT 8%, p =0.01) and R1 resection rate (CRT 0% versus CT 11%, p =0.04) favoured those receiving CRT. The median PFS was 14 and 26 months for CT and CRT respectively (p =0.37). The median OS was 29 months for CT compared with 32 months for CRT (p =0.83). Conclusions: Despite no difference in survival, the improvement from preoperative CRT with respect to margin involvement makes this treatment a reasonable option for bulky, locally advanced resectable adenocarcinoma of the oesophagus. [Copyright &y& Elsevier]
Details
- Language :
- English
- ISSN :
- 09598049
- Volume :
- 47
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- European Journal of Cancer
- Publication Type :
- Academic Journal
- Accession number :
- 57681645
- Full Text :
- https://doi.org/10.1016/j.ejca.2010.09.009