Oesophageal cancer: neoadjuvant chemotherapy vs chemoradiotherapy

  • Pucher PH & al.
  • Eur J Surg Oncol
  • 10 Jul 2020

  • curated by Dawn O'Shea
  • UK Medical News
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A study by researchers at University Hospital Southampton suggests improvements in local tumour response with neoadjuvant chemoradiotherapy (CRT) compared with chemotherapy (CT) may not translate to survival outcomes in oesophageal adenocarcinoma.

The team retrospectively compared CT with CRT using data from 284 patients who received neoadjuvant CT or CRT followed by surgery.

No significant differences were seen for post-operative complications (CT, 64.9% vs CRT, 63.3%; P=.807), including major complications (24.0% vs 23.6%; P=.943) and anastomotic leak (7.8% vs 5.6%; P=.526).

Significantly higher rates of clinical regression and complete pathological response were seen following CRT (P=.002 for both).

Rates of R0 resection were higher with CRT (CT, 79.1% vs CRT, 93.1%; P=.006).

There was no difference between groups for overall or disease-free survival.

Presenting the findings in the European Journal of Surgical Oncology, the authors said the results would appear to suggest that, in the context of currently available evidence, patient selection and response to neoadjuvant therapy may be more important than the choice of neoadjuvant therapy alone.

However, they stressed that adequately powered prospective trials are still lacking.