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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
Main Authors: 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.
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container_end_page 1514
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
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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 &amp; Sons, Ltd. 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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. 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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. 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1365-2168
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source Oxford Journals Online
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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