医学
放化疗
外科
新辅助治疗
癌症
完全响应
内科学
病态的
放射治疗
化疗
乳腺癌
作者
Marloes Jongh,Ben M Eyck,Leonie R. van der Werf,Eelke Toxopeus,J. Jan B. van Lanschot,Sjoerd M. Lagarde,Ate van der Gaast,J. Nuyttens,Bas P. L. Wijnhoven
出处
期刊:BJS open
[Oxford University Press]
日期:2021-03-01
卷期号:5 (2)
被引量:11
标识
DOI:10.1093/bjsopen/zrab022
摘要
Abstract Background Neoadjuvant chemoradiotherapy (nCRT) and surgery is a widely used treatment for locally advanced resectable oesophageal cancer, with 20–50 per cent of patients having a pathological complete response (pCR). Disease, however, still recurs in 20–30 per cent of these patients. The aim of this study was to assess the pattern of recurrence in patients with a pCR after nCRT and surgery. Methods All patients with a pCR after nCRT and surgery included in the phase II and III CROSS (ChemoRadiotherapy for Oesophageal followed by Surgery Study) trials (April 2001 to December 2008) and after the CROSS trials (September 2009 to October 2017) were identified. The site of recurrence was compared with the applied radiation and surgical fields. Outcomes were median time to recurrence, and overall and progression-free survival. Results A total of 141 patients with a median follow-up of 100 (i.q.r. 64–134) months were included. Some 29 of 141 patients (20,6 per cent) developed recurrence. Of these, four had isolated locoregional recurrence, 15 had distant recurrence only, and ten had both locoregional and distant recurrence. Among the 14 patients with locoregional recurrences, five had recurrence within the radiation field, seven outside the radiation field, and two at the border. Median time to recurrence was 24 (10–62) months. The 5-year overall survival rate was 74 per cent and the recurrence-free survival rate was 70 per cent. Conclusion Despite good overall survival, recurrence still occurred in 21 per cent of patients. Most recurrences were distant, outside the radiation and surgical fields.
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