title: Complete response to preoperative chemoradiation and survival in esophageal cancer: a pooled analysis of three single-institution phase II trials.
abstract: This pooled analysis was performed using individual patient data from three phase II trials that included on the whole 113 esophageal cancer treated preoperatively with chemoradiotherapy (CRT), in order to analyze the efficacy and survival outcomes according to the achievement of the pathologic complete response (pCR). Thirty-nine patients were treated with 5-fluorouracil/cisplatin and RT (40 Gy), 33 patients received paclitaxel/cisplatin weekly during weeks 1-6 with and RT (46 Gy), 41 patients were treated with induction bio-chemotherapy with cetuximab and FOLFOX-4 followed by concomitant cetuximab and RT of 50.4 Gy. One hundred and two out of 113 resected patients were included in the survival analysis. The median overall survival (OS) time for the whole population was 21.5 months. The 12, 24, and 36 months OS rates were 85.4, 45.2, and 33%, respectively. The difference in survival probability between patients with pCR and patients with partial response or stable disease after treatment was significant (P= 0.0002, hazard ratios = 0.21, 95% CI 0.18-0.60). On multivariate analysis, the pathologic response and histology were the only covariates independently associated with OS (P= 0.0157 and P= 0.0212, respectively). In our series, complete responder patients had a significant longer survival probability after treatment when compared to patients with partial response or stable disease.
authors.affiliation: Department of Clinical and Experimental Medicine and Surgery F. Magrassi - A. Lanzara, Second University of Naples School of Medicine, Naples, Italy. michele.orditura@unina2.it
authors.forename: M
authors.initials: M
authors.lastname: Orditura
authors.forename: G
authors.initials: G
authors.lastname: Galizia
authors.forename: F
authors.initials: F
authors.lastname: Morgillo
authors.forename: E
authors.initials: E
authors.lastname: Martinelli
authors.forename: E
authors.initials: E
authors.lastname: Lieto
authors.forename: F
authors.initials: F
authors.lastname: Vitiello
authors.forename: N
authors.initials: N
authors.lastname: Di Martino
authors.forename: R
authors.initials: R
authors.lastname: Pacelli
authors.forename: A
authors.initials: A
authors.lastname: Renda
authors.forename: F
authors.initials: F
authors.lastname: Ciardiello
authors.forename: F
authors.initials: F
authors.lastname: De Vita
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D059248:Chemoradiotherapy / Q000379:methods*; D002945:Cisplatin / Q000627:therapeutic use*; D004938:Esophageal Neoplasms / Q000601:surgery / Q000628:therapy*; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000627:therapeutic use*; D057234:Preoperative Period; D012074:Remission Induction; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D017239:Paclitaxel; D002945:Cisplatin; D005472:Fluorouracil