Survival after neoadjuvant chemoradiotherapy and oesophagectomy versus definitive chemoradiotherapy for patients with oesophageal squamous cell carcinoma

2018 ◽  
Vol 106 (3) ◽  
pp. 255-262 ◽  
Author(s):  
B.‐Y. Wang ◽  
S.‐C. Wu ◽  
H.‐C. Chen ◽  
W.‐H. Hung ◽  
C.‐H. Lin ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Neoadjuvant Chemoradiotherapy ◽  
Oesophageal Squamous Cell Carcinoma ◽  
Definitive Chemoradiotherapy

scholarly journals Peri-treatment peripheral blood cell score predicts long-term locoregional progression hazard in oesophageal squamous cell carcinoma after definitive chemoradiotherapy

2019 ◽  
Author(s):  
Jianzhou Chen ◽  
Liangyu Xu ◽  
Hong Guo ◽  
Ruihong Huang ◽  
Longjia Guo ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Disease Progression ◽  
Oesophageal Cancer ◽  
Squamous Cell ◽  
Peripheral Blood ◽  
Tumour Progression ◽  
Oesophageal Squamous Cell Carcinoma ◽  
Definitive Chemoradiotherapy

Abstract Background Prediction of response to chemoradiotherapy is critical for the optimal management of oesophageal cancer, yet it is still an unmet clinical need. This study aims to evaluate the predictive potential of peri-treatment peripheral blood cells (PBC) in disease progression hazard in oesophageal cancer following chemoradiotherapy.Methods 87 patients with primary oesophageal squamous cell carcinoma were subjected to definitive concurrent chemoradiotherapy in a phase II trial. PBC parameters (haemoglobin, neutrophils, platelets, lymphocytes and monocytes) were collected at 7 time points through the course of radiotherapy. The values of peri-treatment PBC parameters in predicting 3-year cumulative hazard of tumour progression were evaluated.Results Patients with disease progression displayed distinct distribution patterns of peri-treatment PBC compared to patients without. Greater prediction capabilities for risk of locoregional disease progression were found in PBC collected after the start of radiotherapy compared to their pretreatment counterparts, and in individual parameters rather than cell-to-cell ratios. The most predictive PBC parameters were integrated by summation and designated as a PBC score (PBCS), which further augmented their predictive power. Patients divided according to their PBCS (high vs medium vs low) had significantly different 3-year cumulative hazards of locoregional progression (58% vs 29% vs 7%, P = 0.0017). Multivariate analysis confirmed that PBCS high (HR 12.2, 95%CI 2.0-76.3, P = 0.007) and medium (HR 5.8, 95%CI 1.2-27.7, P = 0.028) are independent indicators of locoregional progression.Conclusion Peri-treatment PBCS can predict the long-term hazard of locoregional progression after definitive chemoradiotherapy in patients with oesophageal squamous cell carcinoma.

scholarly journals Peri-treatment peripheral blood cell score predicts long-term locoregional progression hazard in oesophageal squamous cell carcinoma after definitive chemoradiotherapy

2020 ◽  
Author(s):  
Liangyu Xu ◽  
Jianzhou Chen ◽  
Hong Guo ◽  
Ruihong Huang ◽  
Longjia Guo ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Disease Progression ◽  
Oesophageal Cancer ◽  
Squamous Cell ◽  
Peripheral Blood ◽  
Tumour Progression ◽  
Oesophageal Squamous Cell Carcinoma ◽  
Definitive Chemoradiotherapy

Abstract Background: Prediction of response to chemoradiotherapy is critical for the optimal management of oesophageal cancer, yet it is still an unmet clinical need. This study aims to evaluate the predictive potential of peri-treatment peripheral blood cells (PBC) in disease progression hazard in oesophageal cancer following chemoradiotherapy.Methods: 87 patients with primary oesophageal squamous cell carcinoma were subjected to definitive concurrent chemoradiotherapy in a phase II trial. PBC parameters (haemoglobin, neutrophils, platelets, lymphocytes and monocytes) were collected at 7 time points through the course of radiotherapy. The values of peri-treatment PBC parameters in predicting 3-year cumulative hazard of tumour progression were evaluated.Results: Patients with disease progression displayed distinct distribution patterns of peri-treatment PBC compared to patients without. Greater prediction capabilities for risk of locoregional disease progression were found in PBC collected after the start of radiotherapy compared to their pretreatment counterparts, and in individual parameters rather than cell-to-cell ratios. The most predictive PBC parameters were integrated by summation and designated as a PBC score (PBCS), which further augmented their predictive power. Patients divided according to their PBCS (high vs medium vs low) had significantly different 3-year cumulative hazards of locoregional progression (58% vs 29% vs 7%, P = 0.0017). Multivariate analysis confirmed that PBCS high (HR 12.2, 95%CI 2.0-76.3, P = 0.007) and medium (HR 5.8, 95%CI 1.2-27.7, P = 0.028) are independent indicators of locoregional progression.Conclusion: Peri-treatment PBCS can predict the long-term hazard of locoregional progression after definitive chemoradiotherapy in patients with oesophageal squamous cell carcinoma.

scholarly journals P-OGC48 Definitive Chemoradiotherapy versus Neoadjuvant Chemoradiotherapy Followed by Radical Surgery for Locally Advanced Esophageal Squamous Cell Carcinoma: Systematic Review and Meta-analysis

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Sivesh K Kamarajah ◽  
Richard Evans ◽  
James Gossage ◽  
Ewen Griffiths ◽  
Phil Pucher
Keyword(s):  
Systematic Review ◽  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Meta Analysis ◽  
Neoadjuvant Chemoradiotherapy ◽  
Current Evidence ◽  
High Quality ◽  
Definitive Chemoradiotherapy

Abstract Background Debate exists surrounding definitive chemoradiotherapy (dCRT) over neoadjuvant chemoradiotherapy and surgery (nCRS) as a primary treatment for esophageal squamous cell carcinoma (ESCC) owing to the heterogeneity in the quality of current evidence. This study aimed to compare long-term survival of dCRT with nCRT for ESCC from high-quality studies. Methods This systematic review was performed according to PRISMA guidelines and eligible studies were identified through a search of PubMed, Scopus and Cochrane CENTRAL databases up to 23rd July 2021. Primary outcome was overall survival (OS) and secondary outcomes were disease-free survival (DFS) and recurrence rates. A meta-analysis was conducted using random-effects modelling to determine pooled adjusted multivariable hazard ratios (HRs). Results This review included ten high-quality studies including 14,092 patients, of which 30% received nCRT. Three studies were randomized controlled trials (RCT), six studies were single-center. dCRT and nCRT regimens were reported in six studies and surgical quality control were reported in two studies. Outcomes for OS and DFS were reported in eight and three studies, respectively. nCRT had significantly longer OS (HR: 0.68, CI95%: 0.54 - 0.87, p < 0.001) and DFS (HR: 0.50, CI95%: 0.36 - 0.70, p < 0.001) than dCRT. Conclusions nCRS followed by planned esophagectomy appears to remain the optimum curative treatment regime in patients with loco-regional ESCC. Thus, surgery remains an integral component of the management of patients with ESCC. As adjuvant and immunotherapy treatment regimens develop, ongoing prospective assessment of the role of radiotherapy in combination with modern treatment modalities should be studied

scholarly journals Outcomes of oesophageal cancer treated with neoadjuvant compared with definitive chemoradiotherapy

2021 ◽  
Vol 50 (7) ◽  
pp. 536-547
Author(s):  
Caryn Wujanto ◽  
Jeremy Tey ◽  
Balamurugan Vellayappan ◽  
Jimmy So ◽  
Wei Peng Yong ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Oesophageal Cancer ◽  
Squamous Cell ◽  
Multivariable Analysis ◽  
Neoadjuvant Chemoradiotherapy ◽  
Disease Free Survival ◽  
Feeding Tube ◽  
Definitive Chemoradiotherapy ◽  
Tube Versus

Introduction: We report outcomes of patients with oesophageal cancer treated with neoadjuvant chemoradiotherapy (NACRT) plus surgery or definitive chemoradiotherapy (chemoRT) at our institution. Methods: We retrospectively reviewed patients who underwent chemoRT from 2005 to 2017. The primary outcome was overall survival (OS). Secondary outcomes were disease-free survival (DFS) and toxicities. Results: We identified 96 patients with median age of 64 years and squamous cell carcinoma in 82.3%. Twenty-nine patients (30.2%) received NACRT plus surgery, 67 patients (69.8%) received definitive chemoRT. Median follow-up was 13.5 months. The 3/5-year OS were 26.4%/13.4%, and 59.6%/51.6% in the definitive chemoRT and NACRT plus surgery groups, respectively. The 3/5-year DFS were 19.3%/12.3%, and 55.7%/37.2% in the definitive chemoRT and NACRT plus surgery groups, respectively. NACRT plus surgery significantly improved OS (hazard ratio [HR] 0.40, 95% confidence interval [CI] 0.22–0.72, P<0.01) and DFS (subhazard ratio [SHR] 5.21, 95 CI 1.20–22.7, P=0.03). Multivariable analysis for OS in the definitive chemoRT group indicated stage (1–2 vs 3–4a; HR 2.17, 95% CI 1.15–4.11, P=0.02) and feeding tube (no tube versus tube; HR 1.85, 95% CI 1.00–3.43, P=0.05) as significantly associated with OS. The cumulative incidence of local recurrence was significantly higher in the definitive chemoRT group (SHR 5.21, 95 CI 1.2022.7, P=0.03). Nineteen patients (65.5%) had postoperative complications. Conclusion: NACRT plus surgery improved OS and DFS. However, in view of treatment-related complications, careful selection of patients is warranted. With the predominant histology of our cohort being squamous cell carcinoma (SCC), our results may be more re levant for those with SCC. Keywords: Neoadjuvant chemoradiotherapy, oesophageal cancer, surgery

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