Definitive Chemoradiotherapy versus Neoadjuvant Chemoradiotherapy Followed by Surgery in Locally Advanced Esophageal Cancer: A Retrospective Evaluation of Clinical Data of Two Centers

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gökhan açıkgöz s., Halis H., Aksakal A. K., akkus yildirim b., Tezcan Y., ERKAL H. S.

ACTA ONCOLOGICA TURCICA, cilt.57, sa.1, ss.22-29, 2024 (TRDizin)

Özet

Aim: The aim of this study is to investigate the results of neoadjuvant chemoradiotherapy /radiotherapy (neo-CRT/RT)+surgery and definitive chemoradiotherapy (def-CRT) approaches in locally advanced esophageal cancer Methods: Between January 2012 and December 2021, in two centers, patients who received def-CRT or neo-CRT/RT with the diagnosis of locally advanced esophageal cancer, were retrospectively analyzed. Cases were evaluated for treatment response, overall survival (OS), disease-free survival (DFS), and local recurrence (LR). Results: In total, fifty cases were included. The median follow-up was 10 months (range 2-26). In the def-CRT group; OS at one year, and two years were 67 % and 32 %, respectively; DFS at one year, and two years were 62 % and 32 % respectively. In the neo-CRT group; OS at one year was 81 % and DFS at one year was 73 %. In the follow-up time, LR was 12.1% in def-CRT and 11.8% in the neo-CRT group. For two treatment arms, there were no significant differences in OS (p=0.404), DFS (p=0.593) and LR (p=0.670). The neo-CRT group was evaluated according to the time of surgery, more mortality was found in patients who underwent surgery after 8 weeks, although statistical significance was not reached. Conclusion: Considering the morbidity and mortality of surgery, def-CRT may be an alternative to neoadjuvant-surgical treatment in selected cases whose treatment response is considered a complete response. In these patients, waiting until recurrence and then salvage surgery can be considered.