OBJECTIVE: To compare the efficacy and safety of induction FOLFOX followed by PET-directed neoadjuvant chemoradiation therapy (nCRT), induction carboplatin plus paclitaxel (CP) followed by PET-directed nCRT, and nCRT with CP alone in patients with esophageal adenocarcinoma (EAC). SUMMARY BACKGROUND DATA: nCRT with CP is a standard treatment for locally advanced EAC. The results of Cancer and Leukemia Group B 80803 support the use of induction chemotherapy followed by PET-directed chemoradiation therapy. METHODS: We retrospectively identified all patients with EAC who underwent the treatments above followed by esophagectomy. We assessed incidences of pathologic complete response (pCR), near-pCR (ypN0 with ≥90% response), and surgical complications between treatment groups using Fisher's exact test and logistic regression; disease-free survival (DFS) and overall survival (OS) were estimated by the Kaplan-Meier method and evaluated using the log-rank test and extended Cox regression. RESULTS: In total, 451 patients were included: 309 (69%) received induction chemotherapy before nCRT (FOLFOX, n=70; CP, n=239); 142 (31%) received nCRT with CP. Rates of pCR (33% vs 16%, P=0.004), near-pCR (57% vs 33%, P<0.001), and 2-year DFS (68% vs 50%, P=0.01) were higher in the induction FOLFOX group than in the induction CP group. Similarly, the rate of near-pCR (57% vs 42%, P=0.04) and 2-year DFS (68% vs 44%, P<0.001) were significantly higher in the FOLFOX group than in the no-induction group. CONCLUSIONS: Induction FOLFOX followed by PET-directed nCRT may result in better histopathologic response rates and DFS than either induction CP plus PET-directed nCRT or nCRT with CP alone.
OBJECTIVE: To compare the efficacy and safety of induction FOLFOX followed by PET-directed neoadjuvant chemoradiation therapy (nCRT), induction carboplatin plus paclitaxel (CP) followed by PET-directed nCRT, and nCRT with CP alone in patients with esophageal adenocarcinoma (EAC). SUMMARY BACKGROUND DATA: nCRT with CP is a standard treatment for locally advanced EAC. The results of Cancer and Leukemia Group B 80803 support the use of induction chemotherapy followed by PET-directed chemoradiation therapy. METHODS: We retrospectively identified all patients with EAC who underwent the treatments above followed by esophagectomy. We assessed incidences of pathologic complete response (pCR), near-pCR (ypN0 with ≥90% response), and surgical complications between treatment groups using Fisher's exact test and logistic regression; disease-free survival (DFS) and overall survival (OS) were estimated by the Kaplan-Meier method and evaluated using the log-rank test and extended Cox regression. RESULTS: In total, 451 patients were included: 309 (69%) received induction chemotherapy before nCRT (FOLFOX, n=70; CP, n=239); 142 (31%) received nCRT with CP. Rates of pCR (33% vs 16%, P=0.004), near-pCR (57% vs 33%, P<0.001), and 2-year DFS (68% vs 50%, P=0.01) were higher in the induction FOLFOX group than in the induction CP group. Similarly, the rate of near-pCR (57% vs 42%, P=0.04) and 2-year DFS (68% vs 44%, P<0.001) were significantly higher in the FOLFOX group than in the no-induction group. CONCLUSIONS: Induction FOLFOX followed by PET-directed nCRT may result in better histopathologic response rates and DFS than either induction CP plus PET-directed nCRT or nCRT with CP alone.
Authors: Lucian R Chirieac; Stephen G Swisher; Jaffer A Ajani; Ritsuko R Komaki; Arlene M Correa; Jeffrey S Morris; Jack A Roth; Asif Rashid; Stanley R Hamilton; Tsung-Teh Wu Journal: Cancer Date: 2005-04-01 Impact factor: 6.860
Authors: David H Ilson; Bruce D Minsky; Geoffrey Y Ku; Valerie Rusch; Nabil Rizk; Manish Shah; David P Kelsen; Marinela Capanu; Laura Tang; Jenny Campbell; Manjit Bains Journal: Cancer Date: 2011-10-11 Impact factor: 6.860
Authors: Kenneth L Meredith; Jill M Weber; Kiran K Turaga; Erin M Siegel; Jim McLoughlin; Sarah Hoffe; Melis Marcovalerio; Nilay Shah; Scott Kelley; Richard Karl Journal: Ann Surg Oncol Date: 2010-02-06 Impact factor: 5.344
Authors: Paul M Schneider; Stephan E Baldus; Ralf Metzger; Martin Kocher; Rudolf Bongartz; Elfriede Bollschweiler; Hartmut Schaefer; Juergen Thiele; Hans P Dienes; Rolf P Mueller; Arnulf H Hoelscher Journal: Ann Surg Date: 2005-11 Impact factor: 12.969
Authors: Nabil P Rizk; Ennapadam Venkatraman; Manjit S Bains; Bernard Park; Raja Flores; Laura Tang; David H Ilson; Bruce D Minsky; Valerie W Rusch Journal: J Clin Oncol Date: 2007-02-10 Impact factor: 44.544
Authors: S Lorenzen; P Thuss-Patience; S E Al-Batran; F Lordick; B Haller; T Schuster; C Pauligk; K Luley; D Bichev; G Schumacher; N Homann Journal: Ann Oncol Date: 2013-04-16 Impact factor: 32.976
Authors: James M Donahue; Francis C Nichols; Zhuo Li; David A Schomas; Mark S Allen; Stephen D Cassivi; Aminah Jatoi; Robert C Miller; Dennis A Wigle; K Robert Shen; Claude Deschamps Journal: Ann Thorac Surg Date: 2009-02 Impact factor: 4.330
Authors: Smita Sihag; Tamar Nobel; Meier Hsu; Sergio De La Torre; Kay See Tan; Yelena Y Janjigian; Geoffrey Y Ku; Laura H Tang; Abraham J Wu; Steven B Maron; Manjit S Bains; David R Jones; Daniela Molena Journal: Ann Surg Date: 2020-11-17 Impact factor: 12.969