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Open Access 01-09-2020 | Adenocarcinoma of the Esophagogastric Junction | Original Article

Modification of preoperative radiochemotherapy for esophageal cancer (CROSS protocol) is safe and efficient with no impact on surgical morbidity

Authors: Matthias Paireder, MD, Gerd Jomrich, Ivan Kristo, Reza Asari, Erwin Rieder, Andrea Beer, Aysegül Ilhan-Mutlu, Matthias Preusser, Rainer Schmid, Sebastian F. Schoppmann, MD, FACS

Published in: Strahlentherapie und Onkologie | Issue 9/2020

Abstract

Purpose

Neoadjuvant radiochemotherapy (RCTH) is proven to be highly effective in the treatment of esophageal cancer (EC). We investigated oncological outcome and morbidity in patients treated with a modified CROSS protocol followed by esophagectomy at our institution.

Methods

Patients with EC receiving neoadjuvant RCTH with paclitaxel and carboplatin and concurrent radiotherapy (46 Gy) followed by esophagectomy were included in this retrospective analysis. Histopathological response, overall survival (OS) and recurrence-free interval (RFI) as well as perioperative morbidity were investigated.

Results

Thirty-six patients (86.1% male, mean age 61.3 years, standard deviation 11.52) received neoadjuvant RCTH before surgery. Sixteen patients (44.4%) were treated for squamous cell cancer, whereas 20 patients (55.6%) had adenocarcinoma. The majority (75%) underwent abdominothoracic esophageal resection. Major complications occurred in 7 patients (19.5%) including anastomotic leakage in 4 patients (11.1%). A R0 resection was achieved in 97.2%. A complete pathological remission was seen in 13 patients (36.1%). Major response, classified as Mandard tumor regression grade 1 and 2, was found in 26 patients (72.2%). Median OS and RFI were not reached.

Conclusions

Neoadjuvant radiotherapy with 46 Gy and concomitant chemotherapy with paclitaxel and carboplatin for the treatment of locally advanced esophageal carcinoma is safe and effective. The results of this modified radiotherapy protocol are encouraging and should be considered in future patient treatment and study designs.

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Title: Modification of preoperative radiochemotherapy for esophageal cancer (CROSS protocol) is safe and efficient with no impact on surgical morbidity
Authors: Matthias Paireder, MD
Gerd Jomrich
Ivan Kristo
Reza Asari
Erwin Rieder
Andrea Beer
Aysegül Ilhan-Mutlu
Matthias Preusser
Rainer Schmid
Sebastian F. Schoppmann, MD, FACS
Publication date: 01-09-2020
Publisher: Springer Berlin Heidelberg
Keywords: Adenocarcinoma of the Esophagogastric Junction
Esophageal Cancer
Gastroesophageal Junction Cancer
Esophagus Resection
Esophageal Cancer
Radiotherapy
Esophagus Resection
Published in: Strahlentherapie und Onkologie / Issue 9/2020
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-020-01594-z

At a glance: The STEP trials

Springer Medicine

Modification of preoperative radiochemotherapy for esophageal cancer (CROSS protocol) is safe and efficient with no impact on surgical morbidity

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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