Multicenter prospective randomized trial comparing standard esophagectomy with chemoradiotherapy for treatment of squamous esophageal cancer: Early results from the Chinese University Research Group for Esophageal Cancer (CURE)
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摘要We conducted a prospective randomized trial to compare the efficacy and survival outcome by chemoradiation with that by esophagectomy as a curative treatment. From July 2000 to December 2004, 80 patients with potentially resectable squamous cell carcinoma of the mid or lower thoracic esophagus were randomized to esophagectomy or chemoradiotherapy. A two- or three-stage esophagectomy with two-field dissection was performed. Patients treated with chemoradiotherapy received continuous 5-fluorouracil infusion (200 mg/m(2)/day) from day I to 42 and cisplatin (60 mg/m(2)) on days 1 and 22. The tumor and regional lymphatics were concomitantly irradiated to a total of 50-60 Gy. Tumor response was assessed by endoscopy, endoscopic ultrasonography, and computed tomography scan. Salvage esophagectomy was performed for incomplete response or recurrence. Forty-four patients received standard esophagectomy, whereas 36 were treated with chemoradiotherapy. Median follow-up was 16.9 months. The operative mortality was 6.8%. The incidence of postoperative complications was 38.6%. No difference in the early cumulative survival was found between the two groups (RR = 0.89; 95% confidence interval, 0.37-2.17; log-rank test P = 0.45). There was no difference in the disease-free survival. Patients treated with surgery had a slightly higher proportion of recurrence in the mediastinum, whereas those treated with chemoradiation sustained a higher proportion of recurrence in the cervical or abdominal regions. Standard esophagectomy or chemoradiotherapy offered similar early clinical outcome and survival for patients with squamous cell carcinoma of the esophagus. The challenge lies in the detection of residue disease after chemoradiotherapy.
著者Chiu PWY, Chan ACW, Leung SF, Leong HT, Kwong KH, Li MKW, Au-Yeung ACM, Chung SCS, Ng EKW
會議名稱19th World Congress of the International-Society-for-Digestive-Surgery
會議開始日08.12.2004
會議完結日11.12.2004
會議地點Yokohama
期刊名稱Journal of Gastrointestinal Surgery
出版年份2005
月份7
日期1
卷號9
期次6
出版社ELSEVIER SCIENCE INC
頁次794 - 802
國際標準期刊號1091-255X
電子國際標準期刊號1873-4626
語言英式英語
關鍵詞carcinoma of esophagus; chemoradiation; chemoradiotherapy; esophagectomy; squamous cell carcinoma
Web of Science 學科類別Gastroenterology & Hepatology; GASTROENTEROLOGY & HEPATOLOGY; Surgery; SURGERY

上次更新時間 2020-30-11 於 01:16