Journal ArticleDOI
Perioperative Chemotherapy Compared With Surgery Alone for Resectable Gastroesophageal Adenocarcinoma: An FNCLCC and FFCD Multicenter Phase III Trial
Marc Ychou,Valérie Boige,Jean-Pierre Pignon,Thierry Conroy,Olivier Bouché,Gilles Lebreton,Muriel Ducourtieux,Laurent Bedenne,Jean-Michel Fabre,B. Saint-Aubert,Jean Genève,Philippe Lasser,Philippe Rougier +12 more
TLDR
In patients with resectable adenocarcinoma of the lower esophagus, GEJ, or stomach, perioperative chemotherapy using fluorouracil plus cisplatin significantly increased the curative resection rate, disease-free survival, and OS.Abstract:
Purpose After curative resection, the prognosis of gastroesophageal adenocarcinoma is poor. This phase III trial was designed to evaluate the benefit in overall survival (OS) of perioperative fluorouracil plus cisplatin in resectable gastroesophageal adenocarcinoma. Patients and Methods Overall, 224 patients with resectable adenocarcinoma of the lower esophagus, gastroesophageal junction (GEJ), or stomach were randomly assigned to either perioperative chemotherapy and surgery (CS group; n 113) or surgery alone (S group; n 111). Chemotherapy consisted of two or three preoperative cycles of intravenous cisplatin (100 mg/m 2 ) on day 1, and a continuous intravenous infusion of fluorouracil (800 mg/m 2 /d) for 5 consecutive days (days 1 to 5) every 28 days and three or four postoperative cycles of the same regimen. The primary end point was OS. Results Compared with the S group, the CS group had a better OS (5-year rate 38% v 24%; hazard ratio [HR] for death: 0.69; 95% CI, 0.50 to 0.95; P .02); and a better disease-free survival (5-year rate: 34% v 19%; HR, 0.65; 95% CI, 0.48 to 0.89; P .003). In the multivariable analysis, the favorable prognostic factors for survival were perioperative chemotherapy (P .01) and stomach tumor localization (P .01). Perioperative chemotherapy significantly improved the curative resection rate (84% v 73%; P .04). Grade 3 to 4 toxicity occurred in 38% of CS patients (mainly neutropenia) but postoperative morbidity was similar in the two groups. Conclusion In patients with resectable adenocarcinoma of the lower esophagus, GEJ, or stomach, perioperative chemotherapy using fluorouracil plus cisplatin significantly increased the curative resection rate, disease-free survival, and OS. J Clin Oncol 29:1715-1721. © 2011 by American Society of Clinical Oncologyread more
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Preoperative Chemoradiotherapy for Esophageal or Junctional Cancer
TL;DR: Preoperative chemoradiotherapy improved survival among patients with potentially curable esophageal or esophagogastric-junction cancer and the regimen was associated with acceptable adverse-event rates.
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines
TL;DR: Lymphedema is a common complication after treatment for breast cancer and factors associated with increased risk of lymphedEMA include extent of axillary surgery, axillary radiation, infection, and patient obesity.
Journal ArticleDOI
Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial
Joel Shapiro,J. Jan B. van Lanschot,Maarten C.C.M. Hulshof,Pieter van Hagen,Mark I. van Berge Henegouwen,Bas P. L. Wijnhoven,Hanneke W. M. van Laarhoven,Grard A. P. Nieuwenhuijzen,Geke A. P. Hospers,Johannes J. Bonenkamp,Miguel A. Cuesta,Reinoud J. B. Blaisse,Olivier R. Busch,Fiebo J. W. ten Kate,Geert-Jan Creemers,Cornelis J. A. Punt,John T. M. Plukker,Henk M.W. Verheul,Ernst Jan Spillenaar Bilgen,Herman van Dekken,Maurice J.C. van der Sangen,Tom Rozema,Katharina Biermann,Jannet C. Beukema,Anna H.M. Piet,Caroline M. van Rij,Janny G. Reinders,Hugo W. Tilanus,Ewout W. Steyerberg,Ate van der Gaast +29 more
TL;DR: Long-term follow-up confirms the overall survival benefits for neoadjuvant chemoradiotherapy in patients with clinically resectable, locally advanced cancer of the oesophagus or Oesophagogastric junction and shows a significant increase in 5-year overall survival.
Journal ArticleDOI
Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal carcinoma: an updated meta-analysis
Katrin Marie Sjoquist,Bryan Burmeister,B. Mark Smithers,B. Mark Smithers,John Zalcberg,R. John Simes,Andrew Barbour,Andrew Barbour,Val Gebski +8 more
TL;DR: This updated meta-analysis provides strong evidence for a survival benefit of neoadjuvant chemoradiotherapy or chemotherapy over surgery alone in patients with oesophageal carcinoma and investigates treatment effects by tumour histology and relations between risk (survival after surgery alone) and effect size.
Journal ArticleDOI
Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial.
Salah-Eddin Al-Batran,Nils Homann,Claudia Pauligk,Thorsten Oliver Goetze,Johannes Meiler,Stefan Kasper,Hans-Georg Kopp,Frank Mayer,Georg Martin Haag,Kim Barbara Luley,U. Lindig,Wolff Schmiegel,Michael Pohl,Jan Stoehlmacher,Gunnar Folprecht,Stephan Probst,Nicole Prasnikar,Wolfgang Fischbach,Rolf Mahlberg,Jörg Trojan,Michael Koenigsmann,Uwe M. Martens,Peter C. Thuss-Patience,Matthias Egger,Andreas Block,Volker Heinemann,Gerald Illerhaus,Markus Moehler,Michael Schenk,Frank Kullmann,Dirk M Behringer,Michael Heike,Daniel Pink,Christian Teschendorf,Carmen Löhr,Helga Bernhard,G. Schuch,Volker Rethwisch,Ludwig Fischer von Weikersthal,Jörg T. Hartmann,Michael Kneba,Severin Daum,Karsten Schulmann,Jörg Weniger,Sebastian Belle,Timo Gaiser,Fuat Oduncu,Martina Güntner,Wael Hozaeel,Alexander Reichart,Elke Jäger,Thomas Kraus,Stefan Mönig,Wolf O. Bechstein,Martin Schuler,Harald Schmalenberg,Ralf Hofheinz,Flot Aio Investigators +57 more
TL;DR: In this article, the safety and efficacy of the docetaxel-based triplet FLOT (fluorouracil plus leucovorin, oxaliplatin, and doceteaxel) as a perioperative therapy for patients with locally advanced, resectable tumours was reported.
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