Ten-Year Outcome of Neoadjuvant Chemoradiotherapy Plus Surgery for Esophageal Cancer: The Randomized Controlled CROSS Trial.

Autor:	Eyck BM; Department of Surgery, Erasmus Medical Center Cancer Institute, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands., van Lanschot JJB; Department of Surgery, Erasmus Medical Center Cancer Institute, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.; Formerly at Department of Surgery, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands., Hulshof MCCM; Department of Radiation Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands., van der Wilk BJ; Department of Surgery, Erasmus Medical Center Cancer Institute, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands., Shapiro J; Department of Surgery, Erasmus Medical Center Cancer Institute, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands., van Hagen P; Department of Surgery, Erasmus Medical Center Cancer Institute, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands., van Berge Henegouwen MI; Department of Surgery, Cancer Center Amsterdam, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands., Wijnhoven BPL; Department of Surgery, Erasmus Medical Center Cancer Institute, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands., van Laarhoven HWM; Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands., Nieuwenhuijzen GAP; Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands., Hospers GAP; Comprehensive Cancer Center, University of Groningen-University Medical Center Groningen, Groningen, the Netherlands., Bonenkamp JJ; Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands., Cuesta MA; Department of Surgery, Amsterdam University Medical Centers, Location VUmc, Amsterdam, the Netherlands., Blaisse RJB; Department of Medical Oncology, Rijnstate Hospital, Arnhem, the Netherlands., Busch OR; Department of Surgery, Cancer Center Amsterdam, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands., Creemers GM; Department of Medical Oncology, Catharina Hospital, Eindhoven, the Netherlands., Punt CJA; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.; Formerly at Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands., Plukker JTM; Department of Surgery, University of Groningen-University Medical Center Groningen, Groningen, the Netherlands., Verheul HMW; Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands.; Formerly at Department of Medical Oncology, Amsterdam University Medical Centers, Location VUmc, Amsterdam, the Netherlands., Spillenaar Bilgen EJ; Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands., van der Sangen MJC; Department of Radiation Oncology, Catharina Hospital, Eindhoven, the Netherlands., Rozema T; Verbeeten Institute, Tilburg, the Netherlands.; Formerly at Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands., Ten Kate FJW; Formerly at Department of Pathology, Erasmus MC-University Medical Center Rotterdam, the Netherlands., Beukema JC; Department of Radiation Oncology, University of Groningen-University Medical Center Groningen, Groningen, the Netherlands., Piet AHM; Department of Radiation Oncology, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands., van Rij CM; Department of Radiation Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands., Reinders JG; Arnhem Radiotherapeutic Institute ARTI, Arnhem, the Netherlands., Tilanus HW; Formerly at Department of Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands., Steyerberg EW; Department of Public Health, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands.; Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands., van der Gaast A; Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.
Jazyk:	angličtina
Zdroj:	Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2021 Jun 20; Vol. 39 (18), pp. 1995-2004. Date of Electronic Publication: 2021 Apr 23.
DOI:	10.1200/JCO.20.03614
Abstrakt:	Purpose: Preoperative chemoradiotherapy according to the chemoradiotherapy for esophageal cancer followed by surgery study (CROSS) has become a standard of care for patients with locally advanced resectable esophageal or junctional cancer. We aimed to assess long-term outcome of this regimen. Methods: From 2004 through 2008, we randomly assigned 366 patients to either five weekly cycles of carboplatin and paclitaxel with concurrent radiotherapy (41.4 Gy in 23 fractions, 5 days per week) followed by surgery, or surgery alone. Follow-up data were collected through 2018. Cox regression analyses were performed to compare overall survival, cause-specific survival, and risks of locoregional and distant relapse. The effect of neoadjuvant chemoradiotherapy beyond 5 years of follow-up was tested with time-dependent Cox regression and landmark analyses. Results: The median follow-up was 147 months (interquartile range, 134-157). Patients receiving neoadjuvant chemoradiotherapy had better overall survival (hazard ratio [HR], 0.70; 95% CI, 0.55 to 0.89). The effect of neoadjuvant chemoradiotherapy on overall survival was not time-dependent ( P value for interaction, P = .73), and landmark analyses suggested a stable effect on overall survival up to 10 years of follow-up. The absolute 10-year overall survival benefit was 13% (38% v 25%). Neoadjuvant chemoradiotherapy reduced risk of death from esophageal cancer (HR, 0.60; 95% CI, 0.46 to 0.80). Death from other causes was similar between study arms (HR, 1.17; 95% CI, 0.68 to 1.99). Although a clear effect on isolated locoregional (HR, 0.40; 95% CI, 0.21 to 0.72) and synchronous locoregional plus distant relapse (HR, 0.43; 95% CI, 0.26 to 0.72) persisted, isolated distant relapse was comparable (HR, 0.76; 95% CI, 0.52 to 1.13). Conclusion: The overall survival benefit of patients with locally advanced resectable esophageal or junctional cancer who receive preoperative chemoradiotherapy according to CROSS persists for at least 10 years. Competing Interests: Mark I. Van Berge HenegouwenConsulting or Advisory Role: Medtronic, Johnson & Johnson, Mylan, Alesi SurgicalResearch Funding: Olympus, StrykerTravel, Accommodations, Expenses: Johnson & Johnson Hanneke W. M. Van LaarhovenConsulting or Advisory Role: Lilly/ImClone, Nordic Group, Bristol Myers Squibb, ServierResearch Funding: Bristol Myers Squibb, Bayer Schering Pharma, Celgene, Janssen-Cilag, Lilly, Nordic Group, Philips Healthcare, Roche, Merck Sharp & Dohme, Servier, Merck KGaATravel, Accommodations, Expenses: AstraZeneca Grard A. P. NieuwenhuijzenHonoraria: Medtronic, LillyConsulting or Advisory Role: MedtronicResearch Funding: Medtronic Geke A. P. HospersConsulting or Advisory Role: Roche, MSD, Amgen, Bristol Myers Squibb, NovartisResearch Funding: Bristol Myers Squibb, Seerave Foundation Cornelis J. A. PuntConsulting or Advisory Role: Nordic Bioscience Henk M. W. VerheulConsulting or Advisory Role: Glycostem Ewout W. SteyerbergPatents, Royalties, Other Intellectual Property: Royalties from Springer for a book “Clinical Prediction Models”No other potential conflicts of interest were reported.
Databáze:	MEDLINE
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