The addition of induction chemotherapy to preoperative, concurrent chemoradiotherapy improves tumor response in patients with esophageal adenocarcinoma

S. Chris Malaisrie, Wayne L. Hofstetter, Arlene M. Correa, Jaffer A. Ajani, Ritsuko R. Komaki, David C. Rice, Ara A. Vaporciyan, Garrett L. Walsh, Jack A. Roth, Tsung T. Wu, Stephen G. Swisher

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

BACKGROUND. Tumor viability assessed by pathologic analysis of resected specimens in patients with preoperatively treated esophageal adenocarcinoma (EAC) is a prognostic indicator. The feasibility of induction chemotherapy followed by concurrent chemoradiotherapy (CCRT) and surgery for patients with locoregionally advanced EAC has been demonstrated. In this study, the authors evaluated the efficacy of CCRT compared with traditional concurrent chemoradiotherapy (CRT). METHODS. The authors retrospectively reviewed 247 consecutive patients with EAC who presented for planned surgery after treatment with either CCRT or CRT from January 1997 through August 2003. Patient demographics, comorbidities, and tumor characteristics were analyzed. Pathologic tumor response, overall survival, and disease-free survival were assessed according to treatment. RESULTS. One hundred seventeen patients received CCRT, and 130 patients received CRT before planned surgical resection. CCRT resulted in a 64% tumor response rate compared with a 51% tumor response rate in the CRT group (odds ratio, 1.73; P = .035). In the CCRT group, the median overall survival was 55 months, and the 3-year overall survival rate was 59%; in the CRT group, the median overall survival was 25 months, and the 3-year overall survival rate was 41% (hazard ratio [HR], 0.69; P = .041). In the CCRT group, the median disease-free survival was 43 months, and the 3-year disease-free survival rate was 54%; in the CRT group, the median disease-free survival was 18 months, and the 3-year disease-free survival rate was 36% (HR, 0.72; P = .047). Subset analysis of patients with clinical Stage III/IVA disease showed a median overall survival of 51 months with a 3-year overall survival rate of 58% in the CCRT group and a median overall survival of 20 months with a 3-year overall survival rate of 28% in the CRT group (HR, 0.57; P = .019). CONCLUSIONS. In patients with EAC, CCRT improved tumor response significantly compared with traditional CRT alone. Overall survival and disease-free survival were increased in patients who received CCRT, especially in the subset of patients who had more advanced disease.

Original languageEnglish (US)
Pages (from-to)967-974
Number of pages8
JournalCancer
Volume107
Issue number5
DOIs
StatePublished - Sep 1 2006
Externally publishedYes

Fingerprint

Induction Chemotherapy
Chemoradiotherapy
Adenocarcinoma
Neoplasms
Disease-Free Survival
Survival Rate
Survival

Keywords

  • Esophageal cancer
  • Induction therapy
  • Neoadjuvant
  • Preoperative
  • Tumor response

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Malaisrie, S. C., Hofstetter, W. L., Correa, A. M., Ajani, J. A., Komaki, R. R., Rice, D. C., ... Swisher, S. G. (2006). The addition of induction chemotherapy to preoperative, concurrent chemoradiotherapy improves tumor response in patients with esophageal adenocarcinoma. Cancer, 107(5), 967-974. https://doi.org/10.1002/cncr.22077

The addition of induction chemotherapy to preoperative, concurrent chemoradiotherapy improves tumor response in patients with esophageal adenocarcinoma. / Malaisrie, S. Chris; Hofstetter, Wayne L.; Correa, Arlene M.; Ajani, Jaffer A.; Komaki, Ritsuko R.; Rice, David C.; Vaporciyan, Ara A.; Walsh, Garrett L.; Roth, Jack A.; Wu, Tsung T.; Swisher, Stephen G.

In: Cancer, Vol. 107, No. 5, 01.09.2006, p. 967-974.

Research output: Contribution to journalArticle

Malaisrie, SC, Hofstetter, WL, Correa, AM, Ajani, JA, Komaki, RR, Rice, DC, Vaporciyan, AA, Walsh, GL, Roth, JA, Wu, TT & Swisher, SG 2006, 'The addition of induction chemotherapy to preoperative, concurrent chemoradiotherapy improves tumor response in patients with esophageal adenocarcinoma', Cancer, vol. 107, no. 5, pp. 967-974. https://doi.org/10.1002/cncr.22077
Malaisrie, S. Chris ; Hofstetter, Wayne L. ; Correa, Arlene M. ; Ajani, Jaffer A. ; Komaki, Ritsuko R. ; Rice, David C. ; Vaporciyan, Ara A. ; Walsh, Garrett L. ; Roth, Jack A. ; Wu, Tsung T. ; Swisher, Stephen G. / The addition of induction chemotherapy to preoperative, concurrent chemoradiotherapy improves tumor response in patients with esophageal adenocarcinoma. In: Cancer. 2006 ; Vol. 107, No. 5. pp. 967-974.
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abstract = "BACKGROUND. Tumor viability assessed by pathologic analysis of resected specimens in patients with preoperatively treated esophageal adenocarcinoma (EAC) is a prognostic indicator. The feasibility of induction chemotherapy followed by concurrent chemoradiotherapy (CCRT) and surgery for patients with locoregionally advanced EAC has been demonstrated. In this study, the authors evaluated the efficacy of CCRT compared with traditional concurrent chemoradiotherapy (CRT). METHODS. The authors retrospectively reviewed 247 consecutive patients with EAC who presented for planned surgery after treatment with either CCRT or CRT from January 1997 through August 2003. Patient demographics, comorbidities, and tumor characteristics were analyzed. Pathologic tumor response, overall survival, and disease-free survival were assessed according to treatment. RESULTS. One hundred seventeen patients received CCRT, and 130 patients received CRT before planned surgical resection. CCRT resulted in a 64{\%} tumor response rate compared with a 51{\%} tumor response rate in the CRT group (odds ratio, 1.73; P = .035). In the CCRT group, the median overall survival was 55 months, and the 3-year overall survival rate was 59{\%}; in the CRT group, the median overall survival was 25 months, and the 3-year overall survival rate was 41{\%} (hazard ratio [HR], 0.69; P = .041). In the CCRT group, the median disease-free survival was 43 months, and the 3-year disease-free survival rate was 54{\%}; in the CRT group, the median disease-free survival was 18 months, and the 3-year disease-free survival rate was 36{\%} (HR, 0.72; P = .047). Subset analysis of patients with clinical Stage III/IVA disease showed a median overall survival of 51 months with a 3-year overall survival rate of 58{\%} in the CCRT group and a median overall survival of 20 months with a 3-year overall survival rate of 28{\%} in the CRT group (HR, 0.57; P = .019). CONCLUSIONS. In patients with EAC, CCRT improved tumor response significantly compared with traditional CRT alone. Overall survival and disease-free survival were increased in patients who received CCRT, especially in the subset of patients who had more advanced disease.",
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T1 - The addition of induction chemotherapy to preoperative, concurrent chemoradiotherapy improves tumor response in patients with esophageal adenocarcinoma

AU - Malaisrie, S. Chris

AU - Hofstetter, Wayne L.

AU - Correa, Arlene M.

AU - Ajani, Jaffer A.

AU - Komaki, Ritsuko R.

AU - Rice, David C.

AU - Vaporciyan, Ara A.

AU - Walsh, Garrett L.

AU - Roth, Jack A.

AU - Wu, Tsung T.

AU - Swisher, Stephen G.

PY - 2006/9/1

Y1 - 2006/9/1

N2 - BACKGROUND. Tumor viability assessed by pathologic analysis of resected specimens in patients with preoperatively treated esophageal adenocarcinoma (EAC) is a prognostic indicator. The feasibility of induction chemotherapy followed by concurrent chemoradiotherapy (CCRT) and surgery for patients with locoregionally advanced EAC has been demonstrated. In this study, the authors evaluated the efficacy of CCRT compared with traditional concurrent chemoradiotherapy (CRT). METHODS. The authors retrospectively reviewed 247 consecutive patients with EAC who presented for planned surgery after treatment with either CCRT or CRT from January 1997 through August 2003. Patient demographics, comorbidities, and tumor characteristics were analyzed. Pathologic tumor response, overall survival, and disease-free survival were assessed according to treatment. RESULTS. One hundred seventeen patients received CCRT, and 130 patients received CRT before planned surgical resection. CCRT resulted in a 64% tumor response rate compared with a 51% tumor response rate in the CRT group (odds ratio, 1.73; P = .035). In the CCRT group, the median overall survival was 55 months, and the 3-year overall survival rate was 59%; in the CRT group, the median overall survival was 25 months, and the 3-year overall survival rate was 41% (hazard ratio [HR], 0.69; P = .041). In the CCRT group, the median disease-free survival was 43 months, and the 3-year disease-free survival rate was 54%; in the CRT group, the median disease-free survival was 18 months, and the 3-year disease-free survival rate was 36% (HR, 0.72; P = .047). Subset analysis of patients with clinical Stage III/IVA disease showed a median overall survival of 51 months with a 3-year overall survival rate of 58% in the CCRT group and a median overall survival of 20 months with a 3-year overall survival rate of 28% in the CRT group (HR, 0.57; P = .019). CONCLUSIONS. In patients with EAC, CCRT improved tumor response significantly compared with traditional CRT alone. Overall survival and disease-free survival were increased in patients who received CCRT, especially in the subset of patients who had more advanced disease.

AB - BACKGROUND. Tumor viability assessed by pathologic analysis of resected specimens in patients with preoperatively treated esophageal adenocarcinoma (EAC) is a prognostic indicator. The feasibility of induction chemotherapy followed by concurrent chemoradiotherapy (CCRT) and surgery for patients with locoregionally advanced EAC has been demonstrated. In this study, the authors evaluated the efficacy of CCRT compared with traditional concurrent chemoradiotherapy (CRT). METHODS. The authors retrospectively reviewed 247 consecutive patients with EAC who presented for planned surgery after treatment with either CCRT or CRT from January 1997 through August 2003. Patient demographics, comorbidities, and tumor characteristics were analyzed. Pathologic tumor response, overall survival, and disease-free survival were assessed according to treatment. RESULTS. One hundred seventeen patients received CCRT, and 130 patients received CRT before planned surgical resection. CCRT resulted in a 64% tumor response rate compared with a 51% tumor response rate in the CRT group (odds ratio, 1.73; P = .035). In the CCRT group, the median overall survival was 55 months, and the 3-year overall survival rate was 59%; in the CRT group, the median overall survival was 25 months, and the 3-year overall survival rate was 41% (hazard ratio [HR], 0.69; P = .041). In the CCRT group, the median disease-free survival was 43 months, and the 3-year disease-free survival rate was 54%; in the CRT group, the median disease-free survival was 18 months, and the 3-year disease-free survival rate was 36% (HR, 0.72; P = .047). Subset analysis of patients with clinical Stage III/IVA disease showed a median overall survival of 51 months with a 3-year overall survival rate of 58% in the CCRT group and a median overall survival of 20 months with a 3-year overall survival rate of 28% in the CRT group (HR, 0.57; P = .019). CONCLUSIONS. In patients with EAC, CCRT improved tumor response significantly compared with traditional CRT alone. Overall survival and disease-free survival were increased in patients who received CCRT, especially in the subset of patients who had more advanced disease.

KW - Esophageal cancer

KW - Induction therapy

KW - Neoadjuvant

KW - Preoperative

KW - Tumor response

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