Preoperative Radioactive Therapy for Esophageal Carcinoma

Iizuka, Toshifumi; Ide, Hiroko; Kakegawa, Teruo; Sasaki, Koichi; Takagi, Iwao; Ando, Nobutoshi; Mori, Shinobu; Arimori, Masaki; Tsugane, Shoichiro

doi:10.1378/chest.93.5.1054

Cited by 58 publications

(4 citation statements)

References 5 publications

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“…Finally, 97 references were identified on 72 original RCTs. In total, 39 studies reported data on prognostic and/or predictive factors for gastric cancer [3,4,5,6,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53] and 33 studies on esophageal cancer [8,10,11,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,…”

Section: Resultsmentioning

confidence: 99%

“…Prognostic factors for the curative treatment of esophageal cancer identified from OS multivariate analyses in at least one RCT. In total, there were 28 RCTs contributing to Figure 3 with 16 investigating neoadjuvant therapy [10,11,54,58,61,62,64,65,66,69,70,73,74,76,80,83], seven definitive chemoradiotherapy [57,60,71,72,75,82,98], three adjuvant therapy [67,77,79], and two radiotherapy alone [63,68]. * Potentially clinically relevant factors according to the criteria described in the method section.…”

Section: Figurementioning

confidence: 99%

See 1 more Smart Citation

Prognostic and Predictive Factors for the Curative Treatment of Esophageal and Gastric Cancer in Randomized Controlled Trials: A Systematic Review and Meta-Analysis

Ende

Veer

Mali

et al. 2019

Cancers

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Background: An overview of promising prognostic variables and predictive subgroups concerning the curative treatment of esophageal and gastric cancer from randomized controlled trials (RCTs) is lacking. Therefore, we conducted a systematic review and meta-analysis. Methods: PubMed, EMBASE, CENTRAL, and ASCO/ESMO conferences were searched up to March 2019 for RCTs on the curative treatment of esophageal or gastric cancer with data on prognostic and/or predictive factors for overall survival. Prognostic factors were deemed potentially clinically relevant according to the following criteria; (1) statistically significant (p < 0.05) in a multivariate analysis, (2) reported in at least 250 patients, and (3) p < 0.05, in ≥ 33% of the total number of patients in RCTs reporting this factor. Predictive factors were potentially clinically-relevant if (1) the p-value for interaction between subgroups was <0.20 and (2) the hazard ratio in one of the subgroups was significant (p < 0.05). Results: For gastric cancer, 39 RCTs were identified (n = 13,530 patients) and, for esophageal cancer, 33 RCTs were identified (n = 8618 patients). In total, we identified 23 potentially clinically relevant prognostic factors for gastric cancer and 16 for esophageal cancer. There were 15 potentially clinically relevant predictive factors for gastric cancer and 10 for esophageal cancer. Conclusion: The identified prognostic and predictive factors can be included and analyzed in future RCTs and be of guidance for nomograms. Further validation should be performed in large patient cohorts.

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Section: Resultsmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

Prognostic and Predictive Factors for the Curative Treatment of Esophageal and Gastric Cancer in Randomized Controlled Trials: A Systematic Review and Meta-Analysis

Ende

Veer

Mali

et al. 2019

Cancers

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“…Except from one study [5], which includes some methodologic bias [6], preoperative radiation therapy failed to improve long-term results in four major controlled clinical trials [7][8][9][10]. In another controlled study [11] postoperative radiation therapy alone led to better results than the combined pre-and postoperative irradiation. Because several noncontrolled or retrospective studies [12][13][14][15] Correspondence to: H.U.…”

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confidence: 99%

Adjuvant postoperative radiation therapy after curative resection of squamous cell carcinoma of the thoracic esophagus: A prospective randomized study

et al. 1995

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Postoperative radiation therapy following curative resection of squamous cell carcinoma of the esophagus was investigated in a prospective randomized study. A group of 33 patients received postoperative radiation therapy and were compared to a control group of 35 patients treated by surgery alone. No statistically significant differences were noted between the two treatment groups concerning overall and disease-free survival rates. Postoperative irradiation significantly increased the incidence of fibrotic strictures of the esophagogastric or esophagocolonic anastomoses and caused a delayed recovery of patients quality of life. Based on these results, we believe that postoperative radiation therapy alone cannot be advocated as a adjuvant therapy following curative resection of squamous cell carcinoma of the esophagus.

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“…Preoperative radiotherapy (Table 1) [29][30][31][32][33][34][35][36][37][38][39][40][41][42] was originally attempted by Nakayama et al more than 30 years ago [29]. Theirs was the first trial of adjuvant therapy for cancer of the esophagus.…”

Section: Preoperative Radiotherapymentioning

confidence: 99%

Adjuvant therapies for cancer of the thoracic esophagus

1994

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During the past four decades, especially in recent years, various active adjuvant therapies combined with surgery have improved the outcome in cases of cancer of the esophagus. However, no optimum adjuvant therapy has been determined. From 1981 to 1992, 341 patients with regional and distant node metastasis who underwent curative surgery were treated with postoperative radiotherapy (RT), postoperative radiochemotherapy (RC), and postoperative aggressive chemotherapy (AGC) in a controlled study in our department of surgery. Five-year survival rates, including operative deaths and unrelated diseases of the former group, were 0% for RT, 19.9% for surgery alone, 39.8% for RC, and 48.2% for AGC. Such rates for the latter group were 6.8% for AGC, 13.3% for surgery alone, and 33.3% for RC. In addition, results of a group study on the effectiveness of three-field node dissection in 715 cases of thoracic esophageal carcinoma by 10 institutions were analyzed. This analysis showed that there were no differences in the 5-year survival rate of curative surgery in cases with positive nodes among the groups treated with surgery alone (SA), with postoperative radiotherapy (PR), and with postoperative chemotherapy (PC). As to the 91 cases with positive cervical nodes, the 3-year survival rates in cases treated with SA (n = 22), PR (n = 20), and PC (n = 49) were 25.3%, 48.1%, and 53.6%, respectively; a significant improvement of survival in these patients. Summaries of studies of preoperative or postoperative radiotherapy, and both multimodal therapies are introduced.

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Preoperative Radioactive Therapy for Esophageal Carcinoma

Cited by 58 publications

References 5 publications

Prognostic and Predictive Factors for the Curative Treatment of Esophageal and Gastric Cancer in Randomized Controlled Trials: A Systematic Review and Meta-Analysis

Prognostic and Predictive Factors for the Curative Treatment of Esophageal and Gastric Cancer in Randomized Controlled Trials: A Systematic Review and Meta-Analysis

Adjuvant postoperative radiation therapy after curative resection of squamous cell carcinoma of the thoracic esophagus: A prospective randomized study

Adjuvant therapies for cancer of the thoracic esophagus

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