Scripties UMCG - Rijksuniversiteit Groningen
 
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The impact of different nCRT schedules on localization of tumor recurrences in esophageal cancer patients

(2016) Jipping, K.

Background: Identification of a different distribution and pattern of recurrent disease in
esophageal cancer (EC) patients is important for a better understanding of tumor biology and the
effect of neoadjuvant chemoradiotherapy (nCRT). This study assessed the influence of two
different nCRT regimens (cisplatin/5-fluorouracil with 50.4 Gy (Cis/5FU) versus
carboplatin/paclitaxel with 41.4 Gy (CROSS)), on the distribution of recurrent disease and distant
metastases in EC patients.
Patient and Methods: In this retrospective study, locally advanced EC patients (stage II/III)
treated between 2002 and 2015 with nCRT followed by a curative intended esophagectomy (open
transthoracic or scopic procedure), were included. The CROSS patients were all treated in the
University Medical Center Groningen in The Netherlands and the Cis/5FU patients were treated
in the Flinders Medical Centre in Australia. We assessed the difference in site-specific tumor
recurrence. We also assessed the 5-year overall survival (OS) and 5-year disease-free survival
(DFS) with univariate and multivariate Cox regression analysis.
Results: One hundred and thirty-eight (n=138) EC patients were included in analysis. The
amount of distant metastases (P=0.039), lung metastases (P=0.017), and peritoneal metastases
(P=0.039) differed significantly between the groups. The treatment schedule was not a
prognostic factor in multivariate Cox regression analysis for both 5-year DFS (P=0.232) and 5-
year OS (P=0.602).
Conclusion: The CROSS and Cis/5FU group differed significantly in the total amount of
recurrences, with more tumor recurrences in the CROSS group. However, the 5-year OS and DFS
did not differ.





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