Neoadjuvant therapy for oesophagogastric cancer.
BACKGROUND
The prognosis after surgery for oesophagogastric cancer remains poor.


METHODS
This review clarifies current indications for neoadjuvant therapy for oesophageal and gastric cancer. A systematic literature research and evaluation of data from international cancer meetings were carried out.


RESULTS
Recently published results of large randomized phase III trials underscore the potential value of neoadjuvant treatment for oesophagogastric cancer. However, it remains uncertain which subgroups of patients should routinely undergo preoperative therapy. Metabolic response evaluation during neoadjuvant treatment is a promising tool for the selection of responding patients.


CONCLUSIONS
Neoadjuvant chemotherapy is a valid option for locally advanced oesophageal and gastric cancer. In the future, more effective and better tolerated treatment strategies, tailored to the specific tumour characteristics of each individual, should be possible.
Lordick
F
F
Department of Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, D-81675 Munich, Germany. f.lordick@lrz.tu-muenchen.de
Stein
H J
HJ
Peschel
C
C
Siewert
J R
JR
D017024:Chemotherapy, Adjuvant / Q000379:methods; D017326:Clinical Trials, Phase III as Topic; D004938:Esophageal Neoplasms / Q000628:therapy*; D005240:Feasibility Studies; D006801:Humans; D020360:Neoadjuvant Therapy / Q000379:methods*; D018714:Radiotherapy, Adjuvant / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D013274:Stomach Neoplasms / Q000628:therapy*