Is concurrent radiation therapy required in patients receiving preoperative chemotherapy for adenocarcinoma of the oesophagus? A randomised phase II trial

Burmeister, Bryan; Thomas, Janine; Burmeister, Elizabeth; Walpole, Euan; Harvey, Jennifer A.; Thomson, Damien; Barbour, Andrew P.; Gotley, D. C.; Smithers, B. Mark

doi:10.1016/j.ejca.2010.09.009

Cited by 300 publications

(268 citation statements)

References 26 publications

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“…However, there were no signiicant diferences in median survival and the 3-year overall survival between the two treatment arms. Burmeister et al [24] received similar results when they evaluated 75 patients with adenocarcinoma. Regarding pCR and R1 resection, chemoradiotherapy was signiicantly more beneicial, but there were no signiicant diferences in median survival.…”

Section: Neoadjuvant Chemotherapysupporting

confidence: 60%

Radiation Therapy for Esophageal Cancer

Buzurović¹,

Daróczi²,

O’Farrell³

et al. 2017

Esophageal Abnormalities

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Esophageal cancer develops in the mucosa of the esophagus and spreads toward the muscle layer. The nonsurgical treatment for localized, deeply invasive esophageal cancer has been external beam radiation therapy (EBRT) and concurrent chemotherapy. Recently, intraluminal brachytherapy showed a strong potential for the improvement of the therapeutic ratio. It was found that the fractionated high dose rate (HDR) brachytherapy ofered beneicial palliation for a longer period of time with more durable symptom control. A similar was concluded for advanced unresectable esophageal cancer in previously irradiated patients. HDR brachytherapy may be a useful salvage treatment option for inoperable patients diagnosed with local esophageal cancer. Although beter local control can be achieved with higher brachytherapy dose, this increases the risk of acute morbidity and late morbidity, especially in the seting of recurrence cancer. It was found that the moderate dose of EBRT and HDR brachytherapy could give a beter local response than EBRT alone.

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Section: Neoadjuvant Chemotherapysupporting

confidence: 60%

Radiation Therapy for Esophageal Cancer

Buzurović¹,

Daróczi²,

O’Farrell³

et al. 2017

Esophageal Abnormalities

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“…Although the trial was stopped early due to poor accrual, there was a trend towards a higher efficacy in the threestep protocol arm than in the neoadjuvant chemotherapy arm (3year diseasefree survival rate: 47.7% vs 27.7%; HR = 0.67; 95%CI: 0.411.07; P = 0.07) [43] . An Australian randomized phase II study reported a significant reduction of the R1 resection rate in a similar population of patients treated with neoadjuvant chemoradiotherapy vs neoadjuvant chemotherapy alone (0% vs 11%, P = 0.04; pathological complete response rates of 31% vs 8%, respectively, P = 0.01) [44] .…”

Section: Combination Of Neoadjuvant Induction Chemotherapy and Chemormentioning

confidence: 99%

Neoadjuvant therapy for gastroesophageal adenocarcinoma

Samalin

Ychou

2016

WJCO

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Gastric and esophageal adenocarcinomas are one of the main causes of cancer-related death worldwide. While the incidence of gastric adenocarcinoma is decreasing, the incidence of gastroesophageal junction adenocarcinoma is rising rapidly in Western countries. Considering that surgical resection is currently the major curative treatment, and that the 5-year survival rate highly depends on the pTNM stage at diagnosis, gastroesophageal adenocarcinoma management is very challenging for oncologists. Several treatment strategies are being evaluated, and among them systemic chemotherapy, to decrease recurrences and improve overall survival. The MAGIC and FNCLCC-FFCD trials showed a survival benefit of perioperative chemotherapy in patients with operable gastric and lower esophageal cancer, and these results had an impact on the European clinical practice. New strategies, including induction chemotherapy followed by preoperative chemoradiotherapy, targeted therapies in combination with perioperative chemotherapy and the new cytotoxic regimens, are currently assessed to improve current standards and help developing patienttailored therapeutic interventions. Core tip: Gastric and esophageal adenocarcinomas are one of the main causes of cancer-related death worldwide. The incidence of gastroesophageal junction adenocarcinoma is rapidly rising in Western countries. Surgical resection is currently the major curative treatment. As the 5-year survival rate highly depends on the pTNM stage, the treatment strategy is very challenging for oncologists. Several treatments, including systemic chemotherapy, are being assessed to prevent recurrences and improve overall survival. New strategies, such as induction chemotherapy followed by preoperative chemoradiotherapy, targeted therapies and new cytotoxic regimens in perioperative chemotherapy, are currently assessed to improve current standards and develop more tailored therapeutic interventions.

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“…The magnitude of benefit was stronger for RT-CT (8.7%) than for CT alone (5.1%). The authors also directly compared RT-CT to CT alone: results were not significantly in favor of RT-CT even if this subgroup analysis was only based on 2 trials (78,79). Further studies will more clearly state if the interesting results of trimodal approach are or are not superior compared to surgery alone and also to preoperative CT alone followed by surgery.…”

Section: Trimodal Approachmentioning

confidence: 99%

Combined Modality Therapy for Thoracic and head and Neck Cancers: A Review of Updated Literature Based on a Consensus Meeting

Franco

Fiorentino

Dionisi³

et al. 2016

Tumori

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Purpose: Combined modality therapy is a mainstay option for thoracic malignancies and head and neck cancers. The integration of different strategies is based on the multidisciplinary approach of modern clinical oncology. Radiation oncologists have to be educated, trained, and updated to provide state-of-the-art care to cancer patients and thus educational meetings are crucial. Methods: The Italian Association of Radiation Oncology Young Members Working Group (AIRO Giovani) organized its 8 th national meeting, focused on combination therapy in lung, esophageal, and head and neck cancer (with a specific focus on larynx-preservation strategies for larynx/hypopharynx tumors), involving young professionals working in Italy. The meeting was addressed to young radiation oncologists, presenting state-of-the-art knowledge, based on the latest evidence in this field. We performed a review of the current literature based on the highlights of the Congress. Results: The multimodality approach of head and neck and thoracic malignancies includes surgery, chemotherapy, and radiotherapy, but also has to take into account new information and data coming from basic and translational research and including molecular biology, genetics, and immunology. All these aspects are crucial for the treatment of non-small-cell lung cancer and esophageal, esophagogastric junction, and larynx/hypopharynx malignancies. The integration of different treatments in the clinical decision-making process to combine therapies is crucial. Conclusions: Combination therapy has proved to be a consolidated approach in these specific oncologic settings, highlighting the importance of multimodality management in modern clinical oncology. Dedicated meetings on specific topics are helpful to improve knowledge and skills of young professionals in radiation oncology.

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Is concurrent radiation therapy required in patients receiving preoperative chemotherapy for adenocarcinoma of the oesophagus? A randomised phase II trial

Cited by 300 publications

References 26 publications

Radiation Therapy for Esophageal Cancer

Radiation Therapy for Esophageal Cancer

Neoadjuvant therapy for gastroesophageal adenocarcinoma

Combined Modality Therapy for Thoracic and head and Neck Cancers: A Review of Updated Literature Based on a Consensus Meeting

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