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Modification of preoperative radiochemotherapy for esophageal cancer (CROSS protocol) is safe and efficient with no impact on surgical morbidity

PURPOSE: Neoadjuvant radiochemotherapy (RCTH) is proven to be highly effective in the treatment of esophageal cancer (EC). We investigated oncological outcome and morbidity in patients treated with a modified CROSS protocol followed by esophagectomy at our institution. METHODS: Patients with EC rece...

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Autores principales: Paireder, Matthias, Jomrich, Gerd, Kristo, Ivan, Asari, Reza, Rieder, Erwin, Beer, Andrea, Ilhan-Mutlu, Aysegül, Preusser, Matthias, Schmid, Rainer, Schoppmann, Sebastian F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7449995/
https://www.ncbi.nlm.nih.gov/pubmed/32055873
http://dx.doi.org/10.1007/s00066-020-01594-z
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author Paireder, Matthias
Jomrich, Gerd
Kristo, Ivan
Asari, Reza
Rieder, Erwin
Beer, Andrea
Ilhan-Mutlu, Aysegül
Preusser, Matthias
Schmid, Rainer
Schoppmann, Sebastian F.
author_facet Paireder, Matthias
Jomrich, Gerd
Kristo, Ivan
Asari, Reza
Rieder, Erwin
Beer, Andrea
Ilhan-Mutlu, Aysegül
Preusser, Matthias
Schmid, Rainer
Schoppmann, Sebastian F.
author_sort Paireder, Matthias
collection PubMed
description PURPOSE: Neoadjuvant radiochemotherapy (RCTH) is proven to be highly effective in the treatment of esophageal cancer (EC). We investigated oncological outcome and morbidity in patients treated with a modified CROSS protocol followed by esophagectomy at our institution. METHODS: Patients with EC receiving neoadjuvant RCTH with paclitaxel and carboplatin and concurrent radiotherapy (46 Gy) followed by esophagectomy were included in this retrospective analysis. Histopathological response, overall survival (OS) and recurrence-free interval (RFI) as well as perioperative morbidity were investigated. RESULTS: Thirty-six patients (86.1% male, mean age 61.3 years, standard deviation 11.52) received neoadjuvant RCTH before surgery. Sixteen patients (44.4%) were treated for squamous cell cancer, whereas 20 patients (55.6%) had adenocarcinoma. The majority (75%) underwent abdominothoracic esophageal resection. Major complications occurred in 7 patients (19.5%) including anastomotic leakage in 4 patients (11.1%). A R0 resection was achieved in 97.2%. A complete pathological remission was seen in 13 patients (36.1%). Major response, classified as Mandard tumor regression grade 1 and 2, was found in 26 patients (72.2%). Median OS and RFI were not reached. CONCLUSIONS: Neoadjuvant radiotherapy with 46 Gy and concomitant chemotherapy with paclitaxel and carboplatin for the treatment of locally advanced esophageal carcinoma is safe and effective. The results of this modified radiotherapy protocol are encouraging and should be considered in future patient treatment and study designs.
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spelling pubmed-74499952020-09-02 Modification of preoperative radiochemotherapy for esophageal cancer (CROSS protocol) is safe and efficient with no impact on surgical morbidity Paireder, Matthias Jomrich, Gerd Kristo, Ivan Asari, Reza Rieder, Erwin Beer, Andrea Ilhan-Mutlu, Aysegül Preusser, Matthias Schmid, Rainer Schoppmann, Sebastian F. Strahlenther Onkol Original Article PURPOSE: Neoadjuvant radiochemotherapy (RCTH) is proven to be highly effective in the treatment of esophageal cancer (EC). We investigated oncological outcome and morbidity in patients treated with a modified CROSS protocol followed by esophagectomy at our institution. METHODS: Patients with EC receiving neoadjuvant RCTH with paclitaxel and carboplatin and concurrent radiotherapy (46 Gy) followed by esophagectomy were included in this retrospective analysis. Histopathological response, overall survival (OS) and recurrence-free interval (RFI) as well as perioperative morbidity were investigated. RESULTS: Thirty-six patients (86.1% male, mean age 61.3 years, standard deviation 11.52) received neoadjuvant RCTH before surgery. Sixteen patients (44.4%) were treated for squamous cell cancer, whereas 20 patients (55.6%) had adenocarcinoma. The majority (75%) underwent abdominothoracic esophageal resection. Major complications occurred in 7 patients (19.5%) including anastomotic leakage in 4 patients (11.1%). A R0 resection was achieved in 97.2%. A complete pathological remission was seen in 13 patients (36.1%). Major response, classified as Mandard tumor regression grade 1 and 2, was found in 26 patients (72.2%). Median OS and RFI were not reached. CONCLUSIONS: Neoadjuvant radiotherapy with 46 Gy and concomitant chemotherapy with paclitaxel and carboplatin for the treatment of locally advanced esophageal carcinoma is safe and effective. The results of this modified radiotherapy protocol are encouraging and should be considered in future patient treatment and study designs. Springer Berlin Heidelberg 2020-02-13 2020 /pmc/articles/PMC7449995/ /pubmed/32055873 http://dx.doi.org/10.1007/s00066-020-01594-z Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Article
Paireder, Matthias
Jomrich, Gerd
Kristo, Ivan
Asari, Reza
Rieder, Erwin
Beer, Andrea
Ilhan-Mutlu, Aysegül
Preusser, Matthias
Schmid, Rainer
Schoppmann, Sebastian F.
Modification of preoperative radiochemotherapy for esophageal cancer (CROSS protocol) is safe and efficient with no impact on surgical morbidity
title Modification of preoperative radiochemotherapy for esophageal cancer (CROSS protocol) is safe and efficient with no impact on surgical morbidity
title_full Modification of preoperative radiochemotherapy for esophageal cancer (CROSS protocol) is safe and efficient with no impact on surgical morbidity
title_fullStr Modification of preoperative radiochemotherapy for esophageal cancer (CROSS protocol) is safe and efficient with no impact on surgical morbidity
title_full_unstemmed Modification of preoperative radiochemotherapy for esophageal cancer (CROSS protocol) is safe and efficient with no impact on surgical morbidity
title_short Modification of preoperative radiochemotherapy for esophageal cancer (CROSS protocol) is safe and efficient with no impact on surgical morbidity
title_sort modification of preoperative radiochemotherapy for esophageal cancer (cross protocol) is safe and efficient with no impact on surgical morbidity
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7449995/
https://www.ncbi.nlm.nih.gov/pubmed/32055873
http://dx.doi.org/10.1007/s00066-020-01594-z
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