Definitive Chemoradiotherapy Versus Neoadjuvant Chemoradiotherapy Followed by Surgery in Locally Advanced Esophageal Cancer: A Retrospective Evaluation of Clinical Data of Two Centers
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Original Article
P: 22-29
2024

Definitive Chemoradiotherapy Versus Neoadjuvant Chemoradiotherapy Followed by Surgery in Locally Advanced Esophageal Cancer: A Retrospective Evaluation of Clinical Data of Two Centers

Acta Haematol Oncol Turc 2024;57(1):22-29
1. Department Of Radiation Oncology, Ankara Bilkent City Hospital, Ankara, Turkey
2. Department Of Radiation Oncology, Sakarya Training And Education Hospital, Sakarya, Turkey
3. Department Of Radiation Oncology, İstanbul Prof.dr. Cemil Taşcıoğlu City Hospital, İstanbul, Turkey
4. Department Of Radiation Oncology, Yildirim Beyazit University, Ankara Bilkent City Hospital, Ankara, Turkey
5.
No information available.
No information available
Received Date: 2023-08-21T22:30:02
Accepted Date: 2024-04-01T09:51:16
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Abstract

INTRODUCTION

The aim of this study is to investigate the results of neoadjuvant chemoradiotherapy /radiotherapy (neo-CRT/RT)+surgery and definitive chemoradiotherapy (def-CRT) approaches in locally advanced esophageal cancer

METHODS

Between January 2012 and December 2021, in two centers, patients who received def-CRT or neo-CRT/RT with the diagnosis of locally advanced esophageal cancer, were retrospectively analyzed. Cases were evaluated for treatment response, overall survival (OS), disease-free survival (DFS), and local recurrence (LR).

RESULTS

In total, fifty cases were included. The median follow-up was 10 months (range 2-26). In the def-CRT group; OS at one year, and two years were 67 % and 32 %, respectively; DFS at one year, and two years were 62 % and 32 % respectively. In the neo-CRT group; OS at one year was 81 % and DFS at one year was 73 %. In the follow-up time, LR was 12.1% in def-CRT and 11.8% in the neo-CRT group. For two treatment arms, there were no significant differences in OS (p=0.404), DFS (p=0.593) and LR (p=0.670). The neo-CRT group was evaluated according to the time of surgery, more mortality was found in patients who underwent surgery after 8 weeks, although statistical significance was not reached.

DISCUSSION AND CONCLUSION

Considering the morbidity and mortality of surgery, def-CRT may be an alternative to neoadjuvant-surgical treatment in selected cases whose treatment response is considered a complete response. In these patients, waiting until recurrence and then salvage surgery can be considered.

Keywords:
Esophageal cancer
chemoradiotherapy
esophagectomy