title: Impact of neoadjuvant chemotherapy and chemoradiotherapy on postoperative cardiopulmonary complications in patients with esophageal cancer.
abstract: The effectiveness of neoadjuvant chemotherapy (nCT) or chemoradiotherapy (nCRT) for esophageal cancer patients is well established. However, neoadjuvant therapy may induce severe adverse effects that could increase postoperative morbidity. The current study evaluated the impacts of nCT and nCRT on postoperative cardiopulmonary complications in patient with esophageal cancer. We conducted a prospective study in esophageal cancer patients who received nCT (n  =  126) or nCRT (n  =  141) prior to surgery. Surgery was performed in all these patients following nCT or nCRT treatment. More patients occurred pneumonia in the nCRT-treated group compared with the nCT group (P < 0.01). The E-velocity (early diastolic filling velocity) decreased significantly (P = 0.026), while the N-terminal pro-brain natriuretic peptide (NT-proBNP) significantly increased (P < 0.01) in patients of the nCRT group compared with patients from the nCT group. Furthermore, a multivariate analysis revealed that nCRT was correlated with the incidence of pneumonia and NT-proBNP level significantly. The nCRT caused more cardiopulmonary toxicity than nCT. The strategies are needed to prevent the postoperative cardiopulmonary complications especially in patients with nCRT treatment.
authors.affiliation: The Second Hospital of Shandong University, Jinan, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Shandong Jiaotong Hospital, Jinan, China.
authors.forename: H
authors.initials: H
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D059186:Chemoradiotherapy, Adjuvant / Q000009:adverse effects* / Q000379:methods; D002945:Cisplatin / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000097:blood / Q000628:therapy*; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D020360:Neoadjuvant Therapy / Q000009:adverse effects* / Q000379:methods; D010446:Peptide Fragments / Q000097:blood; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology*; D011184:Postoperative Period; D011446:Prospective Studies; D011660:Pulmonary Heart Disease / Q000453:epidemiology / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002945:Cisplatin; D005472:Fluorouracil
keywords: chemoradiotherapy; chemotherapy; esophageal cancer; postoperative