Preoperative chemotherapy compared with postoperative adjuvant chemotherapy for squamous cell carcinoma of the thoracic oesophagus with the detection of circulating tumour cells randomized controlled trial
| Autor: | Wenhao Zhang, Chuanliang Peng, Xiaogang Zhao, Yongqiang Wang, Yunpeng Zhao, Lei Shan, Pingping Song, Lu Han |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Esophageal Neoplasms Adjuvant chemotherapy medicine.medical_treatment Antineoplastic Agents Subgroup analysis Gastroenterology Drug Administration Schedule law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Preoperative chemotherapy Basal cell Postoperative Period Stage (cooking) Lymph node Aged Neoplasm Staging Chemotherapy business.industry General Medicine Middle Aged Neoplastic Cells Circulating Esophagectomy Treatment Outcome medicine.anatomical_structure Chemotherapy Adjuvant 030220 oncology & carcinogenesis Preoperative Period Female 030211 gastroenterology & hepatology Surgery Esophageal Squamous Cell Carcinoma business |
| Zdroj: | International Journal of Surgery. 73:1-8 |
| ISSN: | 1743-9191 |
| DOI: | 10.1016/j.ijsu.2019.11.005 |
| Popis: | Background The role of preoperative chemotherapy in the treatment of patients with oesophageal squamous cell carcinoma (ESCC) remains controversial. Chemotherapy followed by surgery was compared with surgery ± chemotherapy, and the detection of circulating tumour cells (CTCs) was performed on all enrolled patients. Methods We randomly assigned patients with resectable tumours to the preoperative chemotherapy group (Pre group) or surgery group (patients who were either given or not given adjuvant chemotherapy according to their postoperative lymph node status, Post group). Blood samples were collected 1–3 days before treatment (including preoperative chemotherapy and surgery) and 7 days after surgery for CTC detection. Results From July 2016 to October 2018, 115 patients were enrolled in the study, of whom 57 were assigned to the Pre group and 58 to the Post group. The proportion of patients with stage III ESCC was 63.16% in the Pre group and 48.28% in the Post group. No patients died during chemotherapy. One patient exhibited a complete response to preoperative chemotherapy, and 13 patients exhibited partial responses. The 2-year progression-free survival (PFS) and overall survival (OS) rates were not significantly different between the Pre and Post groups. In the subgroup analysis, patients with CTC (+) prior to treatments receiving preoperative chemotherapy had a better 2-year PFS (71.90% vs. 38.73%, P = 0.0379). In the Cox proportional hazards regression analysis, platelet count was proven to correlate significantly with disease progression (P = 0.016), and no factors were proven to correlate significantly with mortality after the factors were balanced in the present analysis. Conclusions Preoperative chemotherapy improved the short-term PFS when CTC detection was positive prior to any treatment for patients with stage II or III ESCC. CTC detection may be used as an index to guide individualized strategic decisions regarding preoperative chemotherapy, but more evidence is needed. |
| Databáze: | OpenAIRE |
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