A single institutional phase III trial of preoperative chemotherapy with hyperfractionation radiotherapy plus surgery versus surgery alone for resectable esophageal squamous cell carcinoma

Lee, J.-L.; Park, S. I.; Kim, S.-B.; Jung, Hwoon Yong; Lee, G. H.; Kim, J.-H.; Song, Heon; Cho, K.-J.; Kim, W.-K.; Lee, J.-S.; Kim, S.-H.; Min, Youngkyoung

doi:10.1093/annonc/mdh219

Cited by 308 publications

(210 citation statements)

References 26 publications

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“…Several studies have compared the use of neoadjuvant chemoradiation with surgery alone for patients with oesophageal cancer [81][82][83][84][85][86][87][88][89][90][91][92][93][94][95][96][97] . Although a negative effect of neoadjuvant treatment on postoperative morbidity 91 and mortality 84 was found in two separate studies, most studies could not demonstrate these differences 81-83;85-87,89;92-94 .…”

Section: Multimodality Treatmentmentioning

confidence: 99%

Quality-of-care indicators for oesophageal cancer surgery: A review

Staal

Wouters

Boot

et al. 2010

European Journal of Surgical Oncology

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Section: Multimodality Treatmentmentioning

confidence: 99%

Quality-of-care indicators for oesophageal cancer surgery: A review

Staal

Wouters

Boot

et al. 2010

European Journal of Surgical Oncology

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“…Ten countries, including China, Australia, Japan, Korea, Thailand, United States of America, France, The Netherlands, Ireland and Norway, were included in the RCTs. Of the 22 studies, 20 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) reported OSR1y, 19 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(24)(25)(26)(27) reported OSR3y and 15 (8,(11)(12)(13)(15)(16)(17)(24)(25)(26)(27) reported information...…”

Section: Summary Of Included Studiesmentioning

confidence: 99%

“…As regards pathological type, 5 RCTs (10,15,24,26,27) on adenocarcinoma and 12 studies (7)(8)(9)11,13,14,16,21,23,24,26) on squamous cell carcinoma investigated OSR1y, OSR3y and OSR5y after CRTS or SA for resectable esophageal carcinoma.…”

Section: Summary Of Included Studiesmentioning

confidence: 99%

Traditional and cumulative meta‑analysis: Chemoradiotherapy followed by surgery versus surgery alone for resectable esophageal carcinoma

et al. 2017

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Abstract. The role of neoadjuvant chemoradiotherapy followed by surgery (CRTS) compared with surgery alone (SA) for resectable esophageal carcinoma has been established by several randomized controlled trials (RCTs). The present study aimed to investigate the difference in survival between the two treatments by a review of meta-analyses. Related research indicators were extracted from RCTs investigating CRTS or SA for resectable esophageal carcinoma by searching electronic databases for eligible articles. Outcomes were synthesized by adopting a fixed-or random-effects model with 95% confidence interval (CI). A total of 22 RCTs including 3,419 patients were selected. The odds ratio (OR) (95% CI, P-value), expressed as CRTS vs. SA, was 1.06 (0.94-1.19, P=0.348) for 1-year overall survival rate (OSR1y), 1.38 (1.20-1.58, P<0.001) for 3-year overall survival rate (OSR3y), and 1.42 (1.22-1.66, P<0.001) for 5-year overall survival rate (OSR5y). The R0 resection rate increased in patients treated by CRTS (OR=2.76, 95% CI: 2.15-3.53, P<0.001). CRTS lowered the locoregional cancer recurrence (OR=0.49, 95% CI: 0.36-6.65, P<0.001) and distant metastasis rate (OR=0.76, 95% CI: 0.60-0.97, P=0.02). However, the incidence of postoperative mortality was similar between the two groups (OR=0.97, 95% CI: 0.72-1.32, P=0.87). The subgroup analysis revealed that OSR3y and OSR5y for Asian, European and American populations were significantly higher in the CRTS group compared with those in the SA group (P<0.05). When comparing the OSR1y between the two groups for patients in all three continents, there was no significant difference (P>0.05). Histological subgroup analysis indicated that patients with esophageal adenocarcinoma may benefit from CRTS in terms of OSR1y (OR=1.55, 95% CI: 1.09-2.20, P=0.01), OSR3y (OR=1.77, 95% CI: 1.34-2.36, P<0.0001) and OSR5y (OR=1.92, 95% CI: 1.34-2.75, P=0.0004). The pooled OR of squamous cell carcinoma in terms of OSR3y and OSR5y between the two groups was 1.57 (95% CI: 1.21-2.04, P=0.0006) and 1.69 (95% CI: 1.32-2.16, P<0.0001), respectively, but there was no statistical difference in terms of OSR1y (OR=1.13, 95% CI: 0.88-1.45, P=0.35). Thus, neoadjuvant CRT followed by surgery may improve long-term survival and surgical parameters, and reduce locoregional cancer recurrence and distant metastasis.

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“…There have been numerous randomized trials comparing surgery alone with pre-operative chemoradiotherapy followed by surgery [8][9][10][11][12][13][14] . The earlier studies only involved patients with SCC but more recent ones included both histologies.…”

Section: Pre-operative Chemoradiotherapymentioning

confidence: 99%

Role of radiotherapy in the pre-operative management of carcinoma of the esophagus

Burmeister¹

2015

WJGO

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The use of radiotherapy in the management of carcinoma of the esophagus and gastro-esophageal junction has undergone much evolution over the past 2 decades. Advances to define its role have been slow with meta-analyses often providing the most useful data. In spite of this many institutions around the world are divided about the role of radiotherapy in this disease and attribute different roles to radiotherapy based on clinical stage, tumor site and histology. The purpose of this review is to try to define the role of radiotherapy given our current knowledge base and to review which current and future trials may fill the gaps of knowledge that we currently have. It will also highlight the difficulties in making firm recommendations about the use of radiotherapy especially in a time when technology and treatments are rapidly evolving. Core tip: This review describes the history and development of radiotherapy in the pre-operative setting for resectable esophageal cancer. In particular it focuses on data from multicenter phase Ⅱ and phase Ⅲ trials as well as meta-analyses from across the world. The review concludes with a discussion about the role of new radiation technologies in the management of esophageal cancer.Burmeister BH. Role of radiotherapy in the pre-operative management of carcinoma of the esophagus. World J Gastrointest Oncol 2015; 7(1): 1-5 Available from:

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A single institutional phase III trial of preoperative chemotherapy with hyperfractionation radiotherapy plus surgery versus surgery alone for resectable esophageal squamous cell carcinoma

Abstract: Although preoperative CRT induced high clinical and pathological response, there was no statistically significant benefit in OS and EFS.

Cited by 308 publications

References 26 publications

Quality-of-care indicators for oesophageal cancer surgery: A review

Quality-of-care indicators for oesophageal cancer surgery: A review

Traditional and cumulative meta‑analysis: Chemoradiotherapy followed by surgery versus surgery alone for resectable esophageal carcinoma

Role of radiotherapy in the pre-operative management of carcinoma of the esophagus

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