Radio(chemo)therapy plus resection versus radio(chemo)therapy alone for the treatment of stage III esophageal cancer.
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Radio(chemo)therapy plus resection versus radio(chemo)therapy alone for the treatment of stage III esophageal cancer. / Rades, Dirk; Schulte, Rainer; Yekebas, Emre F.; Homann, Nils; Schild, Steven E; Dunst, Juergen.
In: STRAHLENTHER ONKOL, Vol. 183, No. 1, 1, 2007, p. 10-16.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Radio(chemo)therapy plus resection versus radio(chemo)therapy alone for the treatment of stage III esophageal cancer.
AU - Rades, Dirk
AU - Schulte, Rainer
AU - Yekebas, Emre F.
AU - Homann, Nils
AU - Schild, Steven E
AU - Dunst, Juergen
PY - 2007
Y1 - 2007
N2 - PURPOSE: To compare radio(chemo)therapy with 41.4-50.4 Gy (moderate dose, MD-RCT) plus resection versus radio(chemo)therapy with 59.4-66.6 Gy (higher dose, HD-RCT) alone for outcome in stage III esophageal cancer, and to investigate potential prognostic factors including preradiotherapy (pre-RT) hemoglobin. PATIENTS AND METHODS: 148 patients with stage III esophageal cancer, treated with MD-RCT plus resection (n = 41) or HD-RCT alone (n = 107), were retrospectively evaluated for age, gender, performance status, tumor location, tumor length, stage, histology, grading, number of chemotherapy courses, pre-RT hemoglobin, resection, overall survival (OS), metastases-free survival (MFS), and locoregional control (LC). RESULTS: On univariate analysis, MD-RCT plus resection resulted in better 2-year OS (57% vs. 25%; p = 0.049), 2-year MFS (71% vs. 39%; p = 0.041), and 2-year LC (76% vs. 39%; p = 0.003). On multivariate analysis, results maintained significance for LC (p = 0.021). According to multivariate analysis, pre-RT hemoglobin was associated with OS (p = 0.003), MFS (p = 0.043), and LC (p = 0.041), tumor length with OS (p = 0.002) and MFS (p = 0.017), and the number of chemotherapy courses with OS (p = 0.008). Complications were more frequent in the MD-RCT-plus-surgery group (p <0.001). Acute (p = 0.47) and late toxicity (p = 0.86) were similar in both groups. In patients receiving surgery, R0 resection was superior to R1/2 resection for OS (p <0.001), MFS (p = 0.030), and LC (p <0.001). MD-RCT plus R0 resection was also superior to HD-RCT alone. CONCLUSION: MD-RCT plus resection resulted in better LC than HD-RCT alone. If R0 resection is possible, MD-RCT plus resection appears preferable, as it results in better outcome. If only R1/2 resection can be performed, HD-RCT alone appears preferable regarding outcome and the greater morbidity associated with resection.
AB - PURPOSE: To compare radio(chemo)therapy with 41.4-50.4 Gy (moderate dose, MD-RCT) plus resection versus radio(chemo)therapy with 59.4-66.6 Gy (higher dose, HD-RCT) alone for outcome in stage III esophageal cancer, and to investigate potential prognostic factors including preradiotherapy (pre-RT) hemoglobin. PATIENTS AND METHODS: 148 patients with stage III esophageal cancer, treated with MD-RCT plus resection (n = 41) or HD-RCT alone (n = 107), were retrospectively evaluated for age, gender, performance status, tumor location, tumor length, stage, histology, grading, number of chemotherapy courses, pre-RT hemoglobin, resection, overall survival (OS), metastases-free survival (MFS), and locoregional control (LC). RESULTS: On univariate analysis, MD-RCT plus resection resulted in better 2-year OS (57% vs. 25%; p = 0.049), 2-year MFS (71% vs. 39%; p = 0.041), and 2-year LC (76% vs. 39%; p = 0.003). On multivariate analysis, results maintained significance for LC (p = 0.021). According to multivariate analysis, pre-RT hemoglobin was associated with OS (p = 0.003), MFS (p = 0.043), and LC (p = 0.041), tumor length with OS (p = 0.002) and MFS (p = 0.017), and the number of chemotherapy courses with OS (p = 0.008). Complications were more frequent in the MD-RCT-plus-surgery group (p <0.001). Acute (p = 0.47) and late toxicity (p = 0.86) were similar in both groups. In patients receiving surgery, R0 resection was superior to R1/2 resection for OS (p <0.001), MFS (p = 0.030), and LC (p <0.001). MD-RCT plus R0 resection was also superior to HD-RCT alone. CONCLUSION: MD-RCT plus resection resulted in better LC than HD-RCT alone. If R0 resection is possible, MD-RCT plus resection appears preferable, as it results in better outcome. If only R1/2 resection can be performed, HD-RCT alone appears preferable regarding outcome and the greater morbidity associated with resection.
M3 - SCORING: Zeitschriftenaufsatz
VL - 183
SP - 10
EP - 16
JO - STRAHLENTHER ONKOL
JF - STRAHLENTHER ONKOL
SN - 0179-7158
IS - 1
M1 - 1
ER -