16-covariate propensity score matching between trimodality (TMT)-eligible esophagogastric cancer (EC) patients who had surgery and those who declined surgery after preoperative chemoradiation.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 111-111
Author(s):  
Takashi Taketa ◽  
Lianchun Xiao ◽  
Akihiro Suzuki ◽  
Mariela A. Blum ◽  
Kazuki Sudo ◽  
...  
Keyword(s):  
Median Overall Survival ◽  
Salvage Surgery ◽  
Complete Response ◽  
Preoperative Chemoradiation ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Surgery Group ◽  
Small Series ◽  
Esophagogastric Cancer ◽  
Baseline Characteristics

111 Background: Localized EC patients should receive chemoradiation followed by surgery (TMT). Nevertheless, some patients decline surgery after preoperative chemoradiation. Reports on the outcome of such patients are scant. Methods: Between 2002 and 2011, we identified 622 TMT-eligible EC patients in our databases. Of 622 patients, 425 achieved clinical complete response (negative biopsy and PET in the physiologic range) after preoperative chemoradiation. Of 425, 244 patients underwent surgery but 61 patients declined surgery. We were able to matched 16 covariates between 36 patients who declined surgery and 36 patients who had TMT. Results: Baseline characteristics between the two groups were well-balanced (p=NS). Within this matched cohort, the median overall survival (OS) and relapse-free survival were 57.9 months (95% CI, 27.7-NA), and 18.5 (95% CI, 11.5-30.4) for the declined surgery group and those were 50.8 months (95% CI, 30.7-NA), and 26.5 months (95% CI, 15.5-NA) for the TMT group. OS and RFS for both groups were not different (p=0.28, and 0.45, respectively). However, 11 of 36 patients in the declined surgery group had salvage surgery (median OS was 66.1 months). Conclusions: These provocative results are in a small series but need to be interpreted with caution. Nevertheless, the results reinforce a possibility of esophageal preservation strategy that could encompass biomarkers and sophisticated imaging. Currently, however, trimodality remains the gold standard. Supported by UTMDACC and generous donors.

R-CHOP compared with CHOP in patients with diffuse large B-cell lymphoma (DLCL): Russian experience

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 18536-18536 ◽  
Author(s):  
I. Poddubnaya ◽  
E. Osmanov ◽  
L. Babicheva ◽  
G. Tumyan ◽  
E. Sorokin ◽  
...  
Keyword(s):  
Median Overall Survival ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Complete Response ◽  
Event Free Survival ◽  
Relapse Free Survival ◽  
Bulky Disease ◽  
Free Survival ◽  
Large B Cell Lymphoma

18536 Background: R-CHOP is regarded as the best available treatment for untreated patients with aggressive and indolent B- NHL. Methods: 184 previously untreated patients with DLCL were included in retrospective study: 92 patients were treated by CHOP, 92 patients were treated by CHOP plus rituximab ( R-CHOP ). Age of patients ranged 16–87 years (median 50 years). The median follow- up was 18 months. Compared groups were balanced in all parameters. The advanced stage of disease (III-IV) at diagnosis had 66% patients treated with CHOP and 67,5 % patients treated with R-CHOP. =2 extranodal zones were initially revealed at 35% in CHOP group vs 47% in R- CHOP group. PS of 25 % patients in R-CHOP group and 30% patients in CHOP group was regarded as appropriate 3–4 degrees on ECOG. Increased LDH level was marked at 60% in CHOP-group vs 54% in R-CHOP. 29% patients in R-CHOP group and 21% patients in CHOP group had B-symptoms at diagnosis; bulky disease took place in 53% cases in R-CHOP group and 62% cases in CHOP. High IPI score had 47 % patients in CHOP-group vs 48 % in R-CHOP. Results: Complete response was achieved in 74% of the patients treated with R- CHOP, as compared to 56% of those treated with CHOP alone (p<0,05). Disease progression during treatment was reported in 25% of patients in CHOP group and 18,5% in R-CHOP group. Median overall survival in patients treated with R-CHOP was NS, in patients treated with CHOP alone was 16 months. With a median follow-up of 18 months, 29 (31,5%) events (progression - 18,5%, relapse - 10%, death - 3% ) were observed in the R-CHOP group and 48 (52%) events ( progression - 25%, relapse - 20%, death - 7%) in the CHOP group (p<0,05). Median event-free survival and relapse-free survival in the CHOP group was 12 months, in R-CHOP group NS. Toxicity was equivalent in both groups. Conclusions: We have established better direct efficiency and outcome of R-CHOP in any age of pts. No significant financial relationships to disclose.

scholarly journals Is the Histopathological Subtype Important for Tumor Response to Irradiation in non-metastatic Esophageal Cancers

2020 ◽  
Vol 71 (6) ◽  
pp. 205-211
Author(s):  
Xenia Elena Bacinschi ◽  
Rodica Maricela Anghel ◽  
Monica Irina Stanuica ◽  
Inga Safta ◽  
Alina Paunescu ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Survival Data ◽  
Median Overall Survival ◽  
Neoadjuvant Treatment ◽  
Relapse Free Survival ◽  
Middle Income ◽  
Free Survival ◽  
Middle Income Countries ◽  
Localized Disease ◽  
Histopathological Subtype

Esophageal cancer is still a health problem in middle income countries. The up-front treatment in localized disease is crucial for a better survival. Data from literature are in favor of a better response to radiotherapy of squamous histology. We have run a retrospective study to compare the response of histological subtypes of esophageal cancer to radiotherapy according to irradiation. Of 44 cases (53.7%) of squamous cell localized esophageal carcinoma and 38 (46.3%) of adenocarcinoma, the response after radiotherapy containing multimodal neoadjuvant treatment was 29.5% (13pts) versus 39.5% (15pts) (p=0.475). No correlation was found between histology and tumor shrinkage. Survival was found similar between the two subgroups. Indeed, median relapse free survival was 11 months for both groups with 95% CI [8.86-13.13] or 95% CI [4.526-17.47], log rank 0.394 and median overall survival was 12 months, 95% CI [9.44-14.55] in squamous versus 15 months, 95% [8.30-21.69] in adenocarcinoma cases, log rank 0.195. In univariate regression, the median relapse free survival was significantly associated with irradiation dose and the concomitance of chemotherapy to radiotherapy, while in multivariate analysis only the last variable remained significant: HR 0.425, 95% CI [0.225-0.806], p=0.009. Our analysis showed a tendency to a better response in adenocarcinoma esophageal cancer after multimodal radiotherapy containing treatment.

Surgery of colorectal metastasis in the Optimox 1 study. A GERCOR Study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 3522-3522 ◽  
Author(s):  
N. Perez-Staub ◽  
G. Lledo ◽  
F. Paye ◽  
B. Gayet ◽  
M. Flesch ◽  
...  
Keyword(s):  
Median Overall Survival ◽  
Response Rate ◽  
Disease Free Survival ◽  
Complete Response ◽  
Additional Benefit ◽  
Curative Intent ◽  
Free Survival ◽  
Before And After ◽  
Unresectable Metastasis ◽  
Disease Free

3522 Background: Surgery of metastasis can cure arround 20% of metastatic colorectal cancer (MCRC) patients. The Optimox 1 study achieved a response rate over 50% with FOLFOX therapy in patients (pts) with initially unresectable metastasis which allowed to perform surgery in a significant number of pts (JCO 2006). We report here the results in pts who underwent surgery of metastasis (met). Methods: From jan 2000 to june 2002, 620 previously untreated patients with unresectable metastasis were randomized between FOLFOX4 every two weeks until progression (arm A), or FOLFOX7 for 6 cycles, maintenance without oxaliplatin for 12 cycles and reintroduction of FOLFOX7 (arm B). 101 pts were resected with a curative intent, 57 in arm A and 45 in arm B. Results: Patients characteristics were (arm A/B %): metachronous metastasis 77/51, liver met 82/91, lung met 16/11, other met 7/4, PAL < 3 ULN: 98/97, normal LDH: 52/51. 8% of pts achieved a complete response, 72% a partial response, 16% a stable disease. 89 pts had a single resection, 12 had a two-stage surgery. One patient died in arm B. Eleven pts who relapsed had a second surgery. Resection was radical (R0) for 71 pts (43 in arm A and 28 in arm B), 15 were R1 (margin invasion) and 15 were R2. R0/R1 patients had a median overall survival (OS) of 51 mo in arm A and 38 mo in arm B. Median disease-free survival (DFS) since surgery was 12 mo in arm A and 9 mo in arm B, with no statistical difference. 32% of R0/R1 pts were alive with no progression at 3 years in arm A and 20% in arm B. Median time from randomization to surgery was 8 mo. No difference was found between patients resected before 8 mo (n = 50) and after (n = 37) in OS (39 vs 45 mo, p = .67) nor in DFS (11.6 vs 9.5 mo, p = .24). Neither in pts resected before and after 6 mo in OS (p = .77) and DFS (p = .44). Conclusions: FOLFOX treatment allowed 14 % of unresectable patients to be rescued by surgery. There was no additional benefit to perform surgery after 6 months of therapy compared to early surgery. [Table: see text]

Etoposide and mitoxantrone in newly diagnosed acute myeloid leukemia patients with persistent leukemia after a course of induction therapy with cytarabine and idarubicin

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 7073-7073
Author(s):  
W. M. McHayleh ◽  
R. Redner ◽  
R. Sehgal ◽  
A. Raptis ◽  
M. Agha ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Median Duration ◽  
Induction Therapy ◽  
Myeloid Leukemia ◽  
Complete Response ◽  
Newly Diagnosed ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Grade 3 ◽  
Acute Myeloid

7073 Background: The goal of induction chemotherapy in acute myeloid leukemia (AML) is complete remission with restoration of normal bone marrow. If residual leukemia is present after the first course of induction therapy, patients receive a second course identical to the first or receive a non-cross resistant antileukemic regimen. Methods: In a retrospective study of adult patients with newly-diagnosed AML treated at the University of Pittsburgh Cancer Institute between December 2002 and May 2008, we evaluated the efficacy and toxicity of mitoxantrone (10 mg/m2/d) and etoposide (100 mg/m2/d), both administered intravenously within 5 days as second course therapy of patients not responding to first-course induction therapy with cytarabine and idarubicin. Univariate and multivariate associations between patient characteristics and complete response (CR) were assessed by logistic regression, with overall- and relapse-free survival estimated by Kaplan-Meier analysis. Results: 74 AML patients (mean age 56 years, range: 18–73 years) completed treatment with etoposide and mitoxantrone; 29 (39%) achieved CR. Lower CR rate was associated with unfavorable cytogenetic risk status at diagnosis and higher percent blasts prior to treatment with mitoxantrone and etoposide. Ten (14%) patients died due to infectious complications. No grade 3 or 4 hepatic toxicities were observed. One patient developed grade 3 cardiac toxicity. Median duration of neutrophil recovery following therapy in patients achieving CR was 29 days. Median overall survival was 9.0 months (95% CI 5.8–14.9 months). The 29 patients who achieved CR received postremission therapy: 16 of these eventually relapsed, while 4 others died without evidence of relapse. Median duration of relapse-free survival in these 29 patients was 11.0 months (95% CI: 9.0–19.3 months). Conclusions: Our study suggests that the combination of etoposide and mitoxantorne is an active and well-tolerated regimen as second-course therapy in newly diagnosed AML patients who have persistent leukemia after a first course of induction therapy with cytarabine and idarubicin. No significant financial relationships to disclose.

Survival after surgery in patients with initially resectable metastasis receiving adjuvant/neoadjuvant FOLFOX therapy and in patients who had surgery after FOLFOX therapy

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 4118-4118
Author(s):  
N. Perez-Staub ◽  
B. Chibaudel ◽  
F. Paye ◽  
J. Taieb ◽  
B. Gayet ◽  
...  
Keyword(s):  
Salvage Surgery ◽  
Disease Free Survival ◽  
R0 Resection ◽  
Phase 2 ◽  
Free Survival ◽  
Response To Chemotherapy ◽  
Phase 2 Study ◽  
Baseline Characteristics ◽  
Folfox Chemotherapy ◽  
Disease Free

4118 Background: Surgery of metastases can cure approximately 20% of metastatic colorectal cancer (MCRC). About 15% of MCRC pts are resectable at presentation. Among the other pts, 10 to 30% can benefit from a salvage surgery after response to chemotherapy, improving their prognostic. We report here the results in pts resectable at presentation and in pts who underwent surgery after chemotherapy in phase 2 and 3 studies. Methods: We retrospectively analysed 167 pts who underwent R0/R1 surgery, 46 pts at presentation in a phase 2 study testing a combination of FOLFOX followed by FOLFIRI (MIROX, Taieb JCO 2005), and 121 pts who underwent a salvage surgery after FOLFOX treatment in OPTIMOX1 (Tournigand, JCO 2006) and OPTIMOX2 (Maindrault-Goebel, ASCO 2007) after updating the survival. Results: Patients’ baseline characteristics were (MIROX/OPTIMOX %): median age 56/62 yrs, PS 0 50/73, metachronous metastasis 41/21, ≥ 2 met sites 11/18, liver met 78/88, lung met 11/19, other met 17/10, two-stage surgery 9/10, second surgery after relapse 39/22, R0 resection 91/ 85. 114 among 142 evaluable patients had a response to FOLFOX (80%). Median time from randomisation to surgery was 8 mths in the OPTIMOX group. In the MIROX group, 46% had surgery of metastases before chemotherapy. Median disease-free survival from R0/R1 surgery was 18.6 months in MIROX group vs 9.4 months in OPTIMOX group (p=0.006).Median overall survival was 104.8 months in MIROX group vs 42.6 months in OPTIMOX group (p=0.02). Furthermore, initially resectable remained the strongest prognostic factor in this series. Conclusions: MCRC pts initially resectable at presentation have a better prognosis than pts who underwent a salvage surgery after FOLFOX chemotherapy. No significant financial relationships to disclose.

A comparison of doublet versus triplet chemotherapy regimens for esophagogastric adenocarcinoma (EGC): Is more always better?

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 124-124
Author(s):  
Tiago Felismino ◽  
Ana Caroline Alves ◽  
Audrey Oliveira ◽  
Wilson Luiz da Costa ◽  
Felipe José Fernandez Coimbra ◽  
...  
Keyword(s):  
Cox Model ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Clinical Staging ◽  
Cancer Center ◽  
Newly Diagnosed ◽  
Relapse Free Survival ◽  
Female Ratio ◽  
Free Survival ◽  
Male Female Ratio

124 Background: Recent data showed that a taxane-containing triplet regimen (FLOT) was superior to an anthracycline-containing regimen (ECX/ECF). However, there is no comparison between more costly and toxic triplet (T) regimens versus doublets (D) in the perioperative setting (periCT) of EGC. Methods: A retrospective analysis of patients (pts) with newly diagnosed EGC was carried out at AC Camargo Cancer Center from 2007 to 2015. Pts received either a D with a fluopyrimidine and platin or T with addition of epirubicin or docetaxel. Variables used in the Cox model were age, site, TNM, Lauren subtype and periCT (T versus D). The selection between T and D was at physician's choice. Endpoints were Relapse Free Survival (RFS) and Overall Survival (OS). Results: A total of 128 pts were included. Median age was 59.5y (56.5y for T and 67y for D, respectively). Male/female ratio was 82/46. Sixty-six received T (DCF 26 pts, EOX 28, ECX 8, 4 others) and 62 received D (FOLFOX 47 pts, CF 13, 2 others). Primary site: gastric in 93 pts and 35 EGJ. Main clinical staging cT3 N = 81 (63.3%), cN+ 84 (65.4%). Lauren subtype: intestinal N = 48, diffuse N = 54. Regarding surgery: 114 pts were resected and median lymph nodes removed 30. Pathologic complete response was seen in N = 9 (14.5%) and N = 4 (6.1%) considering D and T regimens, respectively (p = 0.14). In multivariate analysis there was no advantage of T over D regarding RFS (HR = 1.65, 0.87 – 3.11, p = 0.12) or OS (HR = 1.29, 0.65 – 2.57, p = 0.45). The 3y RFS rate was 63.2% for D and 40.6% for T and the 3y OS was 69.4% for D and 56.1% for T. Conclusions: In our analysis outcomes of pts treated with T regimen was not superior to D. Our main T was DCF and D was FOLFOX. We consider that doublet regimens may still have a role in periCT in EGC and could be an option for frail or elderly pts. Future trials are needed to confirm our data.

Effects of anemia correction with epoetin beta in patients receiving radiochemotherapy for advanced cervical cancer

2008 ◽  
Vol 18 (3) ◽  
pp. 515-524 ◽  
Author(s):  
H.-G. STRAUSS ◽  
G. HAENSGEN ◽  
J. DUNST ◽  
C. R.W. HAYWARD ◽  
H.-U. BURGER ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Treatment Failure ◽  
Complete Response ◽  
Control Groups ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Epoetin Beta ◽  
End Point ◽  
And Control

Patients with cervical cancer frequently suffer from anemia. This two-stage, adaptive-design study investigated the effect of anemia correction with epoetin beta on treatment outcomes. Patients with stage IIB–IVA cervical cancer received radiochemotherapy (RCT) and were randomized to epoetin 150 IU/kg three times weekly (n = 34) or standard care (control; n = 40) for up to 12 weeks. Primary end point for stage 1 aimed to establish a correlation between anemia correction and treatment failure (no complete response or relapsing within 6 months after RCT initiation) as a proof of concept before moving into stage 2. Secondary end points included progression/relapse-free survival, overall survival, response to RCT, hemoglobin (Hb) response, and safety. Median baseline Hb was 11.4 and 11.6 g/dL in epoetin and control groups, respectively. At treatment end point, median Hb increased by 1.3 g/dL with epoetin, but decreased by 0.7 g/dL in the control group (P < 0.0001). No significant correlation between Hb increase and treatment failure was demonstrated. There were no significant differences between epoetin and control groups in progression/relapse-free survival (29.4% vs 32.5% patients with events; P = 0.96), overall survival (23.5% vs 12.5% patients with events; P = 0.22) or overall complete response (53% vs 58%; P = 0.86). Adverse events were well matched between groups. This study shows that epoetin beta rapidly, effectively, and safely increases Hb levels in patients with cervical cancer receiving RCT. No positive correlation of Hb increase and improvement in clinical outcomes could be demonstrated.

scholarly journals Treatment of acute lymphoblastic leukemia in adults with intensive induction, consolidation, and maintenance chemotherapy

Blood ◽  
1989 ◽  
Vol 73 (1) ◽  
pp. 57-63
Author(s):  
KK Hussein ◽  
S Dahlberg ◽  
D Head ◽  
CC Waddell ◽  
L Dabich ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Complete Remission ◽  
Lymphoblastic Leukemia ◽  
Complete Response ◽  
Good Prognosis ◽  
Cancer Center ◽  
Significant Prognostic Factor ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Remission Duration

The Southwest Oncology Group conducted a study of acute lymphoblastic leukemia (ALL) in adults over a 5-year period, testing the utility of the L-10M regimen initially described by the group from Memorial Sloan- Kettering Cancer Center. One hundred sixty-eight eligible patients were treated with this intensive combination chemotherapy regimen. One hundred fifteen (68%) achieved complete remission. With the current median follow-up time of 34.5 months, the median durations of remission, relapse-free survival, and overall survival were 22.9, 20.9, and 17.7 months, respectively. Only 35% of the patients over 50 years of age achieved a complete remission. Age was a significant prognostic factor for complete response, survival, relapse-free survival, and remission duration. In addition, a low initial WBC count was found to have a statistically significant association with longer remission duration. Responders between the ages of 20 and 49 years with WBC counts of less than 15,000 appear to have an exceptionally good prognosis.

scholarly journals Treatment of acute lymphoblastic leukemia in adults with intensive induction, consolidation, and maintenance chemotherapy

Blood ◽  
1989 ◽  
Vol 73 (1) ◽  
pp. 57-63 ◽  
Author(s):  
KK Hussein ◽  
S Dahlberg ◽  
D Head ◽  
CC Waddell ◽  
L Dabich ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Complete Remission ◽  
Lymphoblastic Leukemia ◽  
Complete Response ◽  
Good Prognosis ◽  
Cancer Center ◽  
Significant Prognostic Factor ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Remission Duration

Abstract The Southwest Oncology Group conducted a study of acute lymphoblastic leukemia (ALL) in adults over a 5-year period, testing the utility of the L-10M regimen initially described by the group from Memorial Sloan- Kettering Cancer Center. One hundred sixty-eight eligible patients were treated with this intensive combination chemotherapy regimen. One hundred fifteen (68%) achieved complete remission. With the current median follow-up time of 34.5 months, the median durations of remission, relapse-free survival, and overall survival were 22.9, 20.9, and 17.7 months, respectively. Only 35% of the patients over 50 years of age achieved a complete remission. Age was a significant prognostic factor for complete response, survival, relapse-free survival, and remission duration. In addition, a low initial WBC count was found to have a statistically significant association with longer remission duration. Responders between the ages of 20 and 49 years with WBC counts of less than 15,000 appear to have an exceptionally good prognosis.

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