Long‐term results of a randomized controlled trial comparing neoadjuvant Adriamycin, cisplatin, and 5‐fluorouracil vs docetaxel, cisplatin, and 5‐fluorouracil followed by surgery for esophageal cancer (OGSG1003)

Sugimura, Keijiro; Yamasaki, Makoto; Yasuda, Takushi; Yano, Masahiko; Hirao, Motohiro; Fujitani, Kazumasa; Kimura, Yutaka; Miyata, Hiroshi; Motoori, Masaaki; Takeno, Atsushi; Shiraishi, Osamu; Makino, Tomoki; Kii, Takayuki; Satoh, T.; Mori, Masaki; Doki, Yuichiro

doi:10.1002/ags3.12388

Cited by 20 publications

(16 citation statements)

References 23 publications

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“…It is worth noting that no significant difference between DCF and ACF was found in OS; a possible reason is that the follow-up period was too short (34.5 months). Therefore, a follow-up study was conducted to assess the long-term outcomes and analyze the primary endpoint, RFS, as well as secondary endpoints such as OS and recurrence patterns [33]. Consistent with the preliminary results, this study confirmed a better 5-year RFS for DCF (59.9% vs. 40.7%).…”

Section: Progression and Optimization In The Treatment Protocols Of Nctsupporting

confidence: 79%

Recent Progress in the Neoadjuvant Treatment Strategy for Locally Advanced Esophageal Cancer

Hou

Pan

Hao

et al. 2021

Cancers

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Neoadjuvant therapies, primarily chemotherapy and chemoradiotherapy, are able to improve the overall survival (OS) in patients with locally advanced resectable esophageal cancer (EC) based on the results of several randomized clinical trials. The advantage of neoadjuvant therapy is chiefly attributed to the decreased risk of local–regional recurrence and distant metastasis. Thus, it has been recommended as standard treatment for patients with resectable EC. However, several fundamental problems remain. First, the combination of neoadjuvant chemotherapy (nCT), neoadjuvant chemoradiotherapy (nCRT), and surgery for EC patients with different histological types remains controversial. Furthermore, to reduce the toxicity of preoperative chemotherapy and the risk of complications caused by preoperative radiation therapy, the treatment protocols of nCT and nCRT still need to be investigated and optimized by prospective trials. Moreover, for patients with complete clinical response following neoadjuvant therapy, it is worth ascertaining whether a “watch and wait” surveillance plus surgery-as-needed policy is more favorable, as well as, in addition to preoperative chemoradiotherapy, whether immunotherapy, especially when combined with the traditional neoadjuvant therapy regimens, brings new prospects for EC treatment. In this review, we summarize the recent insights into the research progress and existing problems of neoadjuvant therapy for locally advanced resectable EC.

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Section: Progression and Optimization In The Treatment Protocols Of Nctsupporting

confidence: 79%

Recent Progress in the Neoadjuvant Treatment Strategy for Locally Advanced Esophageal Cancer

Hou

Pan

Hao

et al. 2021

Cancers

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“…The postoperative recurrence pattern in patients with preoperative DCF has been analyzed in the OGSG1003 phase Ⅱ trial in 162 patients with resectable esophageal cancer in preoperative DCF or CF plus adriamycin. This study showed that DCF had significantly higher control rates of distant recurrence than CF plus adriamycin (21% vs. 32%, respectively) [12]. In the present study, we compared preoperative CF + RT and DCF for advanced ESCC retrospectively.…”

Section: Discussion/conclusionmentioning

confidence: 83%

“…The DCF regimen is a beneficial preoperative treatment with higher pathological response and better survival [11][12][13][14][15][16][17]. The postoperative recurrence pattern in patients with preoperative DCF has been analyzed in the OGSG1003 phase Ⅱ trial in 162 patients with resectable esophageal cancer in preoperative DCF or CF plus adriamycin.…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…The standard CT regimen including CRT for preoperative intervention has been cisplatin and 5-fluorouracil (CF) therapy [9,10]. However, sufficient effects of triplet regimen with docetaxel, cisplatin, and 5-fluorouracil (DCF) have recently been reported [11][12][13][14][15][16][17]. More recently, a randomized phase III trial focused on preoperative treatment for resectable esophageal cancer (JCOG1109) compared preoperative DCF to CF (standard arm) or CF plus radiation therapy (RT) [18].…”

Section: Introductionmentioning

confidence: 99%

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Recurrence Pattern Comparing Preoperative Chemoradiotherapy and Preoperative Chemotherapy with Docetaxel plus 5-Fluorouracil and Cisplatin for Advanced Esophageal Cancer

et al. 2022

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Background. Preoperative chemoradiation therapy (CRT) or chemotherapy (CT) followed by surgery is currently being administered for advanced esophageal cancer. However, few studies have directly compared CRT and CT for treating locally advanced esophageal carcinoma. This study aimed to assess postoperative recurrence patterns and post-recurrence outcomes in patients with radical esophagectomy after CRT or triplet CT regimen with docetaxel, cisplatin, and 5-fluorouracil (DCF). Methods. This study included 325 consecutive patients with thoracic esophageal cancer who received preoperative CRT or DCF followed by curative esophagectomy between January 2010 and December 2019. We compared recurrence patterns after surgery and post-recurrence treatments between CRT and DCF. Locoregional recurrence was defined as recurrences at the primary tumor site or regional lymph nodes. Distant recurrence was defined as non-regional lymph node recurrences, systemic metastases, malignant pleural effusions, or peritoneal metastases. Results: Among 325 patients, 74 received preoperative CF+RT and 251 received preoperative DCF. A propensity score-matched cohort of 53 with CRT and 53 with DCF was included. CRT patients had tumors located in the upper esophagus and had more advanced cancer than DCF patients; however, no differences in patient characteristics were observed in the matched cohort. CRT patients had better histopathological responses and control of locoregional recurrence than DCF patients. On the other hand, distant recurrence, especially in non-regional lymph node, lung, and pleural dissemination, significantly developed more frequently in CRT patients. Furthermore, CRT patients may have received insufficient post-recurrence treatment owing to fewer treatment options. Therefore, although there was no difference in recurrence rate in the two groups, CRT patients had significantly poorer post-recurrence survival than DCF patients Conclusions. Preoperative DCF could reduce distant recurrence after surgery compared to preoperative CRT. The differences in recurrence patterns can be related to the selection of post-recurrence treatment and their prognosis after recurrence.

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“…The first failure sites were categorized as local, regional nodal, or distant. In previous studies of locally advanced esophageal cancer patients who underwent chemoradiation followed by esophagectomy, the rates were 4.5-67% local, 10-57.9% regional nodal, and 21-32% distant failures [23][24][25][26]. Local failure was correlated with fewer lymph nodes (LNs) assessed and close/positive margins.…”

Section: Discussionmentioning

confidence: 99%

A retrospective study comparing definitive chemoradiotherapy vs. chemoradiotherapy followed by surgery in T4 esophageal squamous cell carcinoma patients who were downstaged after neochemoradiotherapy

et al. 2022

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Background The outcome of patients with T4 esophageal squamous cell carcinoma (ESCC) is extremely poor. Two distinct therapeutic options are currently available for T4 esophageal cancers: neochemoradiotherapy followed by surgery (CRT-S) and definitive chemoradiotherapy (D-CRT). This study aimed to investigate the clinicopathologic characteristics of T4 ESCC in Chinese patients and compare the survival between the two therapeutic options. Methods We retrospectively analyzed 125 patients with clinically unresectable T4 ESCC in Tianjin Medical University Cancer Institute and Hospital from January 2010 to December 2020. Overall survival (OS), progression-free survival (PFS) and associated factors were analyzed. Results A total of 106 of 125 T4 ESCC patients were downstaged of the tumor by neoadjuvant CRT. Among 106 patients, 32 patients underwent CRT-S, and 74 patients underwent D-CRT. Patients in the CRT-S group had a higher OS (20.4 months vs. un-reached median OS, p = 0.037) and PFS (8.6 months vs. 21.0 months, p = 0.008) than those in the D-CRT group. In multivariate analysis, treatment was an independent predictor of PFS. After propensity score matching (PSM), 50 patients (CRT-S = 25; D-CRT = 25) were matched. Among these 50 patients, patients in the CRT-S group had a higher OS (15.6 months vs. un-reached median OS, p = 0.025) and PFS (7.2 months vs. 18.8 months, p = 0.026) than those in the D-CRT group. In multivariate analysis, treatment was an independent predictor for PFS. Conclusion We demonstrated that CRT-S was superior to D-CRT for T4 ESCC patients who were downstaged by neo-CRT with respect to longer OS and PFS. Randomized controlled trials involving large population samples are needed to define the standard treatment for T4 ESCC.

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Long‐term results of a randomized controlled trial comparing neoadjuvant Adriamycin, cisplatin, and 5‐fluorouracil vs docetaxel, cisplatin, and 5‐fluorouracil followed by surgery for esophageal cancer (OGSG1003)

Cited by 20 publications

References 23 publications

Recent Progress in the Neoadjuvant Treatment Strategy for Locally Advanced Esophageal Cancer

Recent Progress in the Neoadjuvant Treatment Strategy for Locally Advanced Esophageal Cancer

Recurrence Pattern Comparing Preoperative Chemoradiotherapy and Preoperative Chemotherapy with Docetaxel plus 5-Fluorouracil and Cisplatin for Advanced Esophageal Cancer

A retrospective study comparing definitive chemoradiotherapy vs. chemoradiotherapy followed by surgery in T4 esophageal squamous cell carcinoma patients who were downstaged after neochemoradiotherapy

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