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Trimodality therapy without a platinum compound for localized carcinoma of the esophagus and gastroesophageal junction
Cancer, 2010-04, Vol.116 (7), p.1656-1663
Ajani, Jaffer A.
Correa, Arlene M.
Walsh, Garrett L.
Komaki, Ritsuko
Lee, Jeffrey H.
Vaporciyan, Ara A.
Rice, David C.
Yao, James C.
Maru, Dipen M.
Hofstetter, Wayne L.
Phan, Alexandria T.
Swisher, Stephen G.
2010
Volltextzugriff (PDF)
Details
Autor(en) / Beteiligte
Ajani, Jaffer A.
Correa, Arlene M.
Walsh, Garrett L.
Komaki, Ritsuko
Lee, Jeffrey H.
Vaporciyan, Ara A.
Rice, David C.
Yao, James C.
Maru, Dipen M.
Hofstetter, Wayne L.
Phan, Alexandria T.
Swisher, Stephen G.
Titel
Trimodality therapy without a platinum compound for localized carcinoma of the esophagus and gastroesophageal junction
Ist Teil von
Cancer, 2010-04, Vol.116 (7), p.1656-1663
Ort / Verlag
Hoboken: Wiley Subscription Services, Inc., A Wiley Company
Erscheinungsjahr
2010
Quelle
MEDLINE
Beschreibungen/Notizen
BACKGROUND: The use of platinum‐based chemoradiation for esophageal cancer is routine, but it is unclear which class of cytotoxic are optimum. It was hypothesized that chemoradiotherapy with fluoropyrimidine, taxane, and camptothecin would have preserved or improved efficacy with no compromise in safety. METHODS: Patients with histologically confirmed, resectable esophageal carcinoma were eligible. In addition to other tests, a baseline endoscopic ultrasonography (EUS) was obtained. Patients were medically fit and had near–normal organ functions. Patients received docetaxel and irinotecan, plus 5–fluorouracil as induction therapy and then the same cytotoxics with 50.4 grays of radiotherapy followed by an attempted surgery. Pathologic complete response (pathCR) at a rate of ≥20% was the primary endpoint. The pathCR and R0 resection were correlated with overall survival (OS). Safety was documented. RESULTS: Fifty‐five patients were enrolled. Seven were women, and the median age was 56 years. Fifty‐three (96%) patients had EUST3, and 41 (75%) had EUSN1 disease. Forty‐three (78%) patients underwent surgery, 20% achieved a pathCR, and 76.4% underwent an R0 resection. The median survival (n = 55 patients) was 43.3 months (range, 19‐75 months). Baseline clinical parameters were not found to be predictive of OS; however, patients with a pathCR (P = .005) and who underwent R0 resection (P ≤ .0001) had an improved OS. There was 1 treatment‐related postsurgical death reported. Grade 3 or 4 toxicity (graded according to the National Cancer Institute Common Toxicity Criteria [version 2.0]) was observed in 62% of patients. CONCLUSIONS: The results of the current study documented that this 3‐drug, noncisplatin‐based chemoradiotherapy was feasible, safe, and active but not better than the published cisplatin‐based chemoradiotherapy. A fluoropyrimidine and another cytotoxic (from any class) may be adequate to establish a baseline chemoradiotherapy regimen to combine biologics. Cancer 2010. © 2010 American Cancer Society. For 55 patients with potentially resectable carcinoma of the esophagus, a novel nonplatinum 3‐drug combination was used with radiation to assess toxicities and the pathologic complete response rate. These data suggested that a fluoropyrimidine with or without another cytotoxic (from any class of cytotoxics) can form a baseline regimen to which biologics can be added.
Sprache
Englisch
Identifikatoren
ISSN: 0008-543X
eISSN: 1097-0142
DOI: 10.1002/cncr.24935
Titel-ID: cdi_crossref_primary_10_1002_cncr_24935
Format
–
Schlagworte
Adenocarcinoma - mortality
,
Adenocarcinoma - therapy
,
Adult
,
Aged
,
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
,
Biological and medical sciences
,
Carcinoma, Squamous Cell - mortality
,
Carcinoma, Squamous Cell - therapy
,
Chemotherapy, Adjuvant
,
Combined Modality Therapy
,
Drug Administration Schedule
,
Esophageal Neoplasms - mortality
,
Esophageal Neoplasms - therapy
,
Esophagogastric Junction
,
Esophagus
,
esophagus cancer
,
Female
,
Gastroenterology. Liver. Pancreas. Abdomen
,
gastroesophageal junction
,
Humans
,
Male
,
Medical sciences
,
Middle Aged
,
nonplatinum chemoradiotherapy regimen
,
platinum
,
Platinum Compounds - therapeutic use
,
Preoperative Care
,
Radiotherapy, Adjuvant
,
trimodality therapy
,
Tumors
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