Chemoradiotherapy Using Carboplatin plus Paclitaxel versus Cisplatin plus Fluorouracil for Esophageal or Gastroesophageal Junction Cancer
| Autor: | Savtaj S. Brar, Carol Jane Swallow, Charles Henry Lim, Hao-Wen Sim, Jennifer J. Knox, Bryan A. Chan, Akina Natori, James Brierley, Osvaldo Espin-Garcia, Rebecca Wong, Jolie Ringash, Eric Chen, Elena Elimova, Sara Hafezi-Bakhtiari, John Kim, Raymond Woo-Jun Jang, Di Maria Jiang, Geoffrey Liu, Patrik Rogalla, Gail Darling, Stephanie Moignard |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Esophageal Neoplasms Paclitaxel Kaplan-Meier Estimate Gastroenterology Disease-Free Survival Carboplatin 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Stomach Neoplasms Internal medicine Antineoplastic Combined Chemotherapy Protocols Humans Medicine 030212 general & internal medicine Survival analysis Aged Aged 80 and over Cisplatin business.industry Cancer Retrospective cohort study Chemoradiotherapy General Medicine Middle Aged medicine.disease Regimen Oncology chemistry Fluorouracil 030220 oncology & carcinogenesis Female Esophagogastric Junction business medicine.drug |
| Zdroj: | Oncology. 99:49-56 |
| ISSN: | 1423-0232 0030-2414 |
| Popis: | Background: Trimodality therapy (TMT) with neoadjuvant chemoradiotherapy (nCRT) using concurrent carboplatin plus paclitaxel (CP) followed by surgery is the standard of care for locoregional esophageal or gastroesophageal junction (GEJ) cancers. Alternatively, nCRT with cisplatin plus fluorouracil (CF) can be used. Definitive chemoradiotherapy (dCRT) with CP or CF can be used if surgery is not planned. In the absence of comparative trials, we aimed to evaluate outcomes of CP and CF in the settings of TMT and dCRT. Methods: A single-site, retrospective cohort study was conducted at the Princess Margaret Cancer Centre to identify all patients who received CRT for locoregional esophageal or GEJ cancer. Overall survival (OS) and disease-free survival (DFS) were assessed using the Kaplan-Meier method and multivariable Cox regression model. The inverse probability treatment weighting (IPTW) method was used for sensitivity analysis. Results: Between 2011 and 2015, 93 patients with esophageal (49%) and GEJ (51%) cancers underwent nCRT (n = 67; 72%) or dCRT (n = 26; 28%). Median age was 62.3 years and 74% were male. Median follow-up was 23.9 months. Comparing CP to CF in the setting of TMT, the OS and DFS rates were similar. In the setting of dCRT, CP was associated with significantly inferior 3-year OS (36 vs. 63%; p = 0.001; HR 3.1; 95% CI: 1.2–7.7) and DFS (0 vs. 41%; p = 0.004; HR 3.6; 95% CI: 1.4–8.9) on multivariable and IPTW sensitivity analyses. Conclusions: TMT with CF and CP produced comparable outcomes. However, for dCRT, CF may be a superior regimen. |
| Databáze: | OpenAIRE |
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