医学
食管癌
福克斯
食管切除术
胃肠病学
化疗
内科学
腺癌
肿瘤科
外科
诱导化疗
结直肠癌
癌症
奥沙利铂
作者
Rebecca Carr,Meier Hsu,Caitlin Harrington,Kay See Tan,Manjit S. Bains,Matthew Bott,David H. Ilson,James M. Isbell,Yelena Y. Janjigian,Steven Brad Maron,Bernard J. Park,Valerie W. Rusch,Smita Sihag,Abraham J. Wu,David R. Jones,Geoffrey Yuyat Ku,Daniela Molena
出处
期刊:Annals of Surgery
[Ovid Technologies (Wolters Kluwer)]
日期:2021-08-13
卷期号:277 (3): e538-e544
被引量:6
标识
DOI:10.1097/sla.0000000000005163
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.
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