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International Journal of Clinical Oncology

Erschienen in:

09.07.2021 | Original Article

Retrospective analysis of neoadjuvant chemotherapy followed by surgery versus definitive chemoradiotherapy with proton beam for locally advanced esophageal squamous cell carcinoma

verfasst von: Koichi Ogawa, Hitoshi Ishikawa, Katsuji Hisakura, Yuichi Hiroshima, Toshikazu Moriwaki, Takeshi Yamada, Yoshiyuki Yamamoto, Yoshimasa Akashi, Yohei Owada, Yusuke Ohara, Tsuyoshi Enomoto, Kinji Furuya, Manami Doi, Osamu Shimomura, Kazuhiro Takahashi, Shinji Hashimoto, Hideyuki Sakurai, Tatsuya Oda

Erschienen in: International Journal of Clinical Oncology | Ausgabe 10/2021

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Abstract

Background

This is the first study to compare the long-term outcomes between neoadjuvant chemotherapy + surgery and definitive chemoradiotherapy with proton beam therapy for locally advanced esophageal squamous cell carcinoma.

Methods

We reviewed patients with clinical stage IB–III esophageal squamous cell carcinoma (UICC 7th edition) who underwent neoadjuvant chemotherapy + surgery or definitive chemoradiotherapy with proton beam therapy (2009–2017). Overall survival, progression-free survival, and recurrence or regrowth rates were compared between the two treatment groups. Subgroup analyses of overall survival according to baseline characteristics were also performed.

Results

Forty-three patients received neoadjuvant chemotherapy + surgery (median follow-up 47.4 months) and 60 received definitive chemoradiotherapy with proton beam therapy (median follow-up 51.5 months). Baseline characteristics were similar between the groups except for sex, tumor location, and cT classification. The neoadjuvant chemotherapy + surgery and definitive chemoradiotherapy with proton beam therapy groups had similar 3-year overall survival rates (73.1% and 61.7%, respectively, hazard ratio: 0.88, 95% confidence interval 0.49–1.58, p = 0.66), 3-year progression-free survival rates (46.5% and 45%, respectively, hazard ratio: 1.03, 95% confidence interval 0.62–1.70, p = 0.92), and recurrence or regrowth rates (53.5% vs. 50.0%, p = 0.84). In the subgroup analysis, favorable survival was observed after definitive chemoradiotherapy with proton beam therapy for cT1–2 disease (hazard ratio 2.58, 95% confidence interval 0.84–7.99) and after neoadjuvant chemotherapy + surgery for cT3 or higher disease (hazard ratio 0.32, 95% confidence interval 0.15–0.67, p-for-interaction = 0.002).

Conclusions

Long-term outcomes were comparable between the treatments. The choice of the treatment according to cT classification might affect survival.

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Titel: Retrospective analysis of neoadjuvant chemotherapy followed by surgery versus definitive chemoradiotherapy with proton beam for locally advanced esophageal squamous cell carcinoma
verfasst von: Koichi Ogawa
Hitoshi Ishikawa
Katsuji Hisakura
Yuichi Hiroshima
Toshikazu Moriwaki
Takeshi Yamada
Yoshiyuki Yamamoto
Yoshimasa Akashi
Yohei Owada
Yusuke Ohara
Tsuyoshi Enomoto
Kinji Furuya
Manami Doi
Osamu Shimomura
Kazuhiro Takahashi
Shinji Hashimoto
Hideyuki Sakurai
Tatsuya Oda
Publikationsdatum: 09.07.2021
Verlag: Springer Singapore
Erschienen in: International Journal of Clinical Oncology / Ausgabe 10/2021
Print ISSN: 1341-9625
Elektronische ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-021-01981-1

Springer Medizin

Retrospective analysis of neoadjuvant chemotherapy followed by surgery versus definitive chemoradiotherapy with proton beam for locally advanced esophageal squamous cell carcinoma