D. A. Chichevatov, E. Sinev, A. Glukhov, O. M. Seliverstova
{"title":"Neoadjuvant chemoradiotherapy for thoracic esophageal squamous cell carcinoma: does everyone need it?","authors":"D. A. Chichevatov, E. Sinev, A. Glukhov, O. M. Seliverstova","doi":"10.21294/1814-4861-2024-23-2-15-25","DOIUrl":null,"url":null,"abstract":"Objective. In accordance with clinical guidelines, neoadjuvant chemoradiotherapy (nCRT) is recommended as a beneficial option for treatment of thoracic esophageal squamous cell carcinoma (TESCC). However, some studies did not demonstrate potential benefits of nCRT. In this paper we compared treatment outcomes of surgery alone with preoperative CRT followed by surgery. Material and methods. Group 1 (n=147) consisted of patients who underwent surgery alone. Group 2 (n=3,337) was formed in the framework of the present systematic review and meta-analysis (15 publications captured 20 separate subgroups for analysis). Patients of group 2 received nCRT followed by esophagectomy. Overall survival (OS) and median OS were estimated. Results. The median OS was reached in group 1 and in 12 separate subgroups of group 2 (2310 of 3337 patients). In groups 1 and 2 the OS median estimates were 31.0 and 28.1, respectively (p=0.873). Respective 3-year and 5-year OS were 0.49 vs 0.48 (p=0.425) and 0.37 vs 0.41 (p=0.228). The median OS was not reached in 8 separate subgroups of group 2 (1027 of 3337 patients). In this case, group 2 patients had significantly higher 3- and 5-year OS compared to group 1 patients: 0.69 vs 0.49 (p=0.000) and 0.60 vs 0.37 (p=0.000), respectively. Pathological complete response to nCRT was associated with better survival. conclusion. nCRT is not appropriate for all patients with TESCC. Improved overall survival may be achieved in patients with a high grade of pathological tumor response to neoadjuvant treatment. Selective administration of nCRT based on highly probable prediction of complete tumor response seems promising. This concept needs further research.","PeriodicalId":21881,"journal":{"name":"Siberian journal of oncology","volume":" 15","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Siberian journal of oncology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.21294/1814-4861-2024-23-2-15-25","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Objective. In accordance with clinical guidelines, neoadjuvant chemoradiotherapy (nCRT) is recommended as a beneficial option for treatment of thoracic esophageal squamous cell carcinoma (TESCC). However, some studies did not demonstrate potential benefits of nCRT. In this paper we compared treatment outcomes of surgery alone with preoperative CRT followed by surgery. Material and methods. Group 1 (n=147) consisted of patients who underwent surgery alone. Group 2 (n=3,337) was formed in the framework of the present systematic review and meta-analysis (15 publications captured 20 separate subgroups for analysis). Patients of group 2 received nCRT followed by esophagectomy. Overall survival (OS) and median OS were estimated. Results. The median OS was reached in group 1 and in 12 separate subgroups of group 2 (2310 of 3337 patients). In groups 1 and 2 the OS median estimates were 31.0 and 28.1, respectively (p=0.873). Respective 3-year and 5-year OS were 0.49 vs 0.48 (p=0.425) and 0.37 vs 0.41 (p=0.228). The median OS was not reached in 8 separate subgroups of group 2 (1027 of 3337 patients). In this case, group 2 patients had significantly higher 3- and 5-year OS compared to group 1 patients: 0.69 vs 0.49 (p=0.000) and 0.60 vs 0.37 (p=0.000), respectively. Pathological complete response to nCRT was associated with better survival. conclusion. nCRT is not appropriate for all patients with TESCC. Improved overall survival may be achieved in patients with a high grade of pathological tumor response to neoadjuvant treatment. Selective administration of nCRT based on highly probable prediction of complete tumor response seems promising. This concept needs further research.
期刊介绍:
The main objectives of the journal are: -to promote the establishment of Russia’s leading worldwide positions in the field of experimental and clinical oncology- to create the international discussion platform intended to cover all aspects of basic and clinical cancer research, including carcinogenesis, molecular biology, epidemiology, cancer prevention, diagnosis and multimodality treatment (surgery, chemotherapy, radiation therapy, hormone therapy), anesthetic management, medical and social rehabilitation, palliative care as well as the improvement of life quality of cancer patients- to encourage promising young scientists to be actively involved in cancer research programs- to provide a platform for researches and doctors all over the world to promote, share, and discuss various new issues and developments in cancer related problems. (to create a communication platform for the expansion of cooperation between Russian and foreign professional associations).- to provide the information about the latest worldwide achievements in different fields of oncology The most important tasks of the journal are: -to encourage scientists to publish their research results- to offer a forum for active discussion on topics of major interest - to invite the most prominent Russian and foreign authors to share their latest research findings with cancer research community- to promote the exchange of research information, clinical experience, current trends and the recent developments in the field of oncology as well as to review interesting cases encountered by colleagues all over the world- to expand the editorial board and reviewers with the involvement of well-known Russian and foreign experts- to provide open access to full text articles- to include the journal into the international database- to increase the journal’s impact factor- to promote the journal to the International and Russian markets