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Prospective cohort comparison of neoadjuvant chemoradiotherapy versus chemotherapy in patients with oesophageal cancer
Background: Chemotherapy and chemoradiotherapy are common neoadjuvant treatments for resectable T3 N0–1 M0 oesophageal carcinoma. The aim of this study was to compare the outcomes of these therapies in consecutive cohorts of patients. Methods: Between January 1998 and December 2001, 88 patients rece...
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Published in: | British journal of surgery 2007-12, Vol.94 (12), p.1509-1514 |
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container_issue | 12 |
container_start_page | 1509 |
container_title | British journal of surgery |
container_volume | 94 |
creator | Morgan, M. A. Lewis, W. G. Crosby, T. D. L. Escofet, X. Roberts, S. A. Brewster, A. E. Harvard, T. J. Clark, G. W. B. |
description | Background:
Chemotherapy and chemoradiotherapy are common neoadjuvant treatments for resectable T3 N0–1 M0 oesophageal carcinoma. The aim of this study was to compare the outcomes of these therapies in consecutive cohorts of patients.
Methods:
Between January 1998 and December 2001, 88 patients received neoadjuvant chemoradiotherapy (two cycles of cisplatin and 5‐fluorouracil (5‐FU), prior to 45 Gy in 25 F concurrent radiotherapy with cisplatin and 5‐FU). From 2002, 117 patients received neoadjuvant chemotherapy (76 patients had two cycles of cisplatin and 41 had four cycles of epirubicin, cisplatin and 5‐FU). The primary outcome measure was survival, and analysis was by intention to treat.
Results:
Postoperative morbidity and mortality rates were 56 per cent (40 patients) and 10 per cent (seven patients) respectively in the chemoradiotherapy group, compared with 47 per cent (46 patients) and 1 per cent (one patient) in the chemotherapy group (P = 0·008). The cumulative 5‐year survival rate by intention to treat was 35 per cent after chemoradiotherapy versus 21 per cent after chemotherapy (P = 0·188). The cumulative corrected 5‐year survival rate after completed treatment was 44 per cent for chemoradiotherapy compared with 25 per cent for chemotherapy (P = 0·032).
Conclusion:
Neoadjuvant chemoradiotherapy should remain an option for patients with satisfactory performance status. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Both treatments are effective |
doi_str_mv | 10.1002/bjs.5671 |
format | article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_68542819</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>68542819</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3881-6033b1ad7bb5c6dcd554a59a8480961d7e4bf0ab1bb908e5e39dfc9ead8902503</originalsourceid><addsrcrecordid>eNpFkU-P0zAUxC0EYsuCxCdAucAtix3Hjn2Eii1_VrASII7Wi_NCXJI4aydd-u1x1S49jfTmp5HmDSEvGb1ilBZv6228ErJij8iKcSnygkn1mKwopVXOeMEvyLMYt5QyTkXxlFywStOCar4iu9vg44R2djvMrO98mJMMEwQX_Zj5NhvRQ7NddjAmp8PBB2icnzsMMO2zHYa4xKPxcHNjNsHscJxjdu_mLvMY_dTBb4Q-szBaDM_Jkxb6iC9Oekl-Xn_4sf6Y33zbfFq_u8ktV4rlknJeM2iquhZWNrYRogShQZWKasmaCsu6pVCzutZUoUCum9ZqhEalgoLyS_LmmDsFf7dgnM3gosW-h1RriUYqURaK6QS-OoFLPWBjpuAGCHvz8KkEvD4BEC30bUg9XDxzWkktyyJx-ZG7dz3uzz41h6VMWsocljLvP38_6Jl3cca__3kIf4yseCXMr68bIzTTm9v1F3PN_wF0Q5eQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>68542819</pqid></control><display><type>article</type><title>Prospective cohort comparison of neoadjuvant chemoradiotherapy versus chemotherapy in patients with oesophageal cancer</title><source>Oxford Journals Online</source><creator>Morgan, M. A. ; Lewis, W. G. ; Crosby, T. D. L. ; Escofet, X. ; Roberts, S. A. ; Brewster, A. E. ; Harvard, T. J. ; Clark, G. W. B.</creator><creatorcontrib>Morgan, M. A. ; Lewis, W. G. ; Crosby, T. D. L. ; Escofet, X. ; Roberts, S. A. ; Brewster, A. E. ; Harvard, T. J. ; Clark, G. W. B.</creatorcontrib><description>Background:
Chemotherapy and chemoradiotherapy are common neoadjuvant treatments for resectable T3 N0–1 M0 oesophageal carcinoma. The aim of this study was to compare the outcomes of these therapies in consecutive cohorts of patients.
Methods:
Between January 1998 and December 2001, 88 patients received neoadjuvant chemoradiotherapy (two cycles of cisplatin and 5‐fluorouracil (5‐FU), prior to 45 Gy in 25 F concurrent radiotherapy with cisplatin and 5‐FU). From 2002, 117 patients received neoadjuvant chemotherapy (76 patients had two cycles of cisplatin and 41 had four cycles of epirubicin, cisplatin and 5‐FU). The primary outcome measure was survival, and analysis was by intention to treat.
Results:
Postoperative morbidity and mortality rates were 56 per cent (40 patients) and 10 per cent (seven patients) respectively in the chemoradiotherapy group, compared with 47 per cent (46 patients) and 1 per cent (one patient) in the chemotherapy group (P = 0·008). The cumulative 5‐year survival rate by intention to treat was 35 per cent after chemoradiotherapy versus 21 per cent after chemotherapy (P = 0·188). The cumulative corrected 5‐year survival rate after completed treatment was 44 per cent for chemoradiotherapy compared with 25 per cent for chemotherapy (P = 0·032).
Conclusion:
Neoadjuvant chemoradiotherapy should remain an option for patients with satisfactory performance status. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Both treatments are effective</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.5671</identifier><identifier>PMID: 17902093</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biological and medical sciences ; Cisplatin - administration & dosage ; Cohort Studies ; Epirubicin - administration & dosage ; Esophageal Neoplasms - drug therapy ; Esophageal Neoplasms - radiotherapy ; Esophageal Neoplasms - surgery ; Female ; Fluorouracil - administration & dosage ; General aspects ; Humans ; Male ; Medical sciences ; Middle Aged ; Miscellaneous ; Neoplasm Recurrence, Local - etiology ; Prospective Studies ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Radiotherapy, Adjuvant ; Survival Analysis ; Treatment Outcome</subject><ispartof>British journal of surgery, 2007-12, Vol.94 (12), p.1509-1514</ispartof><rights>Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</rights><rights>2008 INIST-CNRS</rights><rights>Copyright (c) 2007 British Journal of Surgery Society Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3881-6033b1ad7bb5c6dcd554a59a8480961d7e4bf0ab1bb908e5e39dfc9ead8902503</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19869642$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17902093$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Morgan, M. A.</creatorcontrib><creatorcontrib>Lewis, W. G.</creatorcontrib><creatorcontrib>Crosby, T. D. L.</creatorcontrib><creatorcontrib>Escofet, X.</creatorcontrib><creatorcontrib>Roberts, S. A.</creatorcontrib><creatorcontrib>Brewster, A. E.</creatorcontrib><creatorcontrib>Harvard, T. J.</creatorcontrib><creatorcontrib>Clark, G. W. B.</creatorcontrib><title>Prospective cohort comparison of neoadjuvant chemoradiotherapy versus chemotherapy in patients with oesophageal cancer</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background:
Chemotherapy and chemoradiotherapy are common neoadjuvant treatments for resectable T3 N0–1 M0 oesophageal carcinoma. The aim of this study was to compare the outcomes of these therapies in consecutive cohorts of patients.
Methods:
Between January 1998 and December 2001, 88 patients received neoadjuvant chemoradiotherapy (two cycles of cisplatin and 5‐fluorouracil (5‐FU), prior to 45 Gy in 25 F concurrent radiotherapy with cisplatin and 5‐FU). From 2002, 117 patients received neoadjuvant chemotherapy (76 patients had two cycles of cisplatin and 41 had four cycles of epirubicin, cisplatin and 5‐FU). The primary outcome measure was survival, and analysis was by intention to treat.
Results:
Postoperative morbidity and mortality rates were 56 per cent (40 patients) and 10 per cent (seven patients) respectively in the chemoradiotherapy group, compared with 47 per cent (46 patients) and 1 per cent (one patient) in the chemotherapy group (P = 0·008). The cumulative 5‐year survival rate by intention to treat was 35 per cent after chemoradiotherapy versus 21 per cent after chemotherapy (P = 0·188). The cumulative corrected 5‐year survival rate after completed treatment was 44 per cent for chemoradiotherapy compared with 25 per cent for chemotherapy (P = 0·032).
Conclusion:
Neoadjuvant chemoradiotherapy should remain an option for patients with satisfactory performance status. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Both treatments are effective</description><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Cisplatin - administration & dosage</subject><subject>Cohort Studies</subject><subject>Epirubicin - administration & dosage</subject><subject>Esophageal Neoplasms - drug therapy</subject><subject>Esophageal Neoplasms - radiotherapy</subject><subject>Esophageal Neoplasms - surgery</subject><subject>Female</subject><subject>Fluorouracil - administration & dosage</subject><subject>General aspects</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Neoplasm Recurrence, Local - etiology</subject><subject>Prospective Studies</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Radiotherapy, Adjuvant</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><recordid>eNpFkU-P0zAUxC0EYsuCxCdAucAtix3Hjn2Eii1_VrASII7Wi_NCXJI4aydd-u1x1S49jfTmp5HmDSEvGb1ilBZv6228ErJij8iKcSnygkn1mKwopVXOeMEvyLMYt5QyTkXxlFywStOCar4iu9vg44R2djvMrO98mJMMEwQX_Zj5NhvRQ7NddjAmp8PBB2icnzsMMO2zHYa4xKPxcHNjNsHscJxjdu_mLvMY_dTBb4Q-szBaDM_Jkxb6iC9Oekl-Xn_4sf6Y33zbfFq_u8ktV4rlknJeM2iquhZWNrYRogShQZWKasmaCsu6pVCzutZUoUCum9ZqhEalgoLyS_LmmDsFf7dgnM3gosW-h1RriUYqURaK6QS-OoFLPWBjpuAGCHvz8KkEvD4BEC30bUg9XDxzWkktyyJx-ZG7dz3uzz41h6VMWsocljLvP38_6Jl3cca__3kIf4yseCXMr68bIzTTm9v1F3PN_wF0Q5eQ</recordid><startdate>200712</startdate><enddate>200712</enddate><creator>Morgan, M. A.</creator><creator>Lewis, W. G.</creator><creator>Crosby, T. D. L.</creator><creator>Escofet, X.</creator><creator>Roberts, S. A.</creator><creator>Brewster, A. E.</creator><creator>Harvard, T. J.</creator><creator>Clark, G. W. B.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>200712</creationdate><title>Prospective cohort comparison of neoadjuvant chemoradiotherapy versus chemotherapy in patients with oesophageal cancer</title><author>Morgan, M. A. ; Lewis, W. G. ; Crosby, T. D. L. ; Escofet, X. ; Roberts, S. A. ; Brewster, A. E. ; Harvard, T. J. ; Clark, G. W. B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3881-6033b1ad7bb5c6dcd554a59a8480961d7e4bf0ab1bb908e5e39dfc9ead8902503</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Cisplatin - administration & dosage</topic><topic>Cohort Studies</topic><topic>Epirubicin - administration & dosage</topic><topic>Esophageal Neoplasms - drug therapy</topic><topic>Esophageal Neoplasms - radiotherapy</topic><topic>Esophageal Neoplasms - surgery</topic><topic>Female</topic><topic>Fluorouracil - administration & dosage</topic><topic>General aspects</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Neoplasm Recurrence, Local - etiology</topic><topic>Prospective Studies</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Radiotherapy, Adjuvant</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Morgan, M. A.</creatorcontrib><creatorcontrib>Lewis, W. G.</creatorcontrib><creatorcontrib>Crosby, T. D. L.</creatorcontrib><creatorcontrib>Escofet, X.</creatorcontrib><creatorcontrib>Roberts, S. A.</creatorcontrib><creatorcontrib>Brewster, A. E.</creatorcontrib><creatorcontrib>Harvard, T. J.</creatorcontrib><creatorcontrib>Clark, G. W. B.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Morgan, M. A.</au><au>Lewis, W. G.</au><au>Crosby, T. D. L.</au><au>Escofet, X.</au><au>Roberts, S. A.</au><au>Brewster, A. E.</au><au>Harvard, T. J.</au><au>Clark, G. W. B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prospective cohort comparison of neoadjuvant chemoradiotherapy versus chemotherapy in patients with oesophageal cancer</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2007-12</date><risdate>2007</risdate><volume>94</volume><issue>12</issue><spage>1509</spage><epage>1514</epage><pages>1509-1514</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background:
Chemotherapy and chemoradiotherapy are common neoadjuvant treatments for resectable T3 N0–1 M0 oesophageal carcinoma. The aim of this study was to compare the outcomes of these therapies in consecutive cohorts of patients.
Methods:
Between January 1998 and December 2001, 88 patients received neoadjuvant chemoradiotherapy (two cycles of cisplatin and 5‐fluorouracil (5‐FU), prior to 45 Gy in 25 F concurrent radiotherapy with cisplatin and 5‐FU). From 2002, 117 patients received neoadjuvant chemotherapy (76 patients had two cycles of cisplatin and 41 had four cycles of epirubicin, cisplatin and 5‐FU). The primary outcome measure was survival, and analysis was by intention to treat.
Results:
Postoperative morbidity and mortality rates were 56 per cent (40 patients) and 10 per cent (seven patients) respectively in the chemoradiotherapy group, compared with 47 per cent (46 patients) and 1 per cent (one patient) in the chemotherapy group (P = 0·008). The cumulative 5‐year survival rate by intention to treat was 35 per cent after chemoradiotherapy versus 21 per cent after chemotherapy (P = 0·188). The cumulative corrected 5‐year survival rate after completed treatment was 44 per cent for chemoradiotherapy compared with 25 per cent for chemotherapy (P = 0·032).
Conclusion:
Neoadjuvant chemoradiotherapy should remain an option for patients with satisfactory performance status. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Both treatments are effective</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>17902093</pmid><doi>10.1002/bjs.5671</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult Aged Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biological and medical sciences Cisplatin - administration & dosage Cohort Studies Epirubicin - administration & dosage Esophageal Neoplasms - drug therapy Esophageal Neoplasms - radiotherapy Esophageal Neoplasms - surgery Female Fluorouracil - administration & dosage General aspects Humans Male Medical sciences Middle Aged Miscellaneous Neoplasm Recurrence, Local - etiology Prospective Studies Public health. Hygiene Public health. Hygiene-occupational medicine Radiotherapy, Adjuvant Survival Analysis Treatment Outcome |
title | Prospective cohort comparison of neoadjuvant chemoradiotherapy versus chemotherapy in patients with oesophageal cancer |
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