Format

Send to

Choose Destination
See comment in PubMed Commons below
Int J Surg. 2014;12(3):196-9. doi: 10.1016/j.ijsu.2013.12.005. Epub 2013 Dec 19.

What is the best neoadjuvant regimen prior to oesophagectomy: chemotherapy or chemoradiotherapy?

Author information

1
Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Edgbaston, B15 2WB, United Kingdom. Electronic address: emmamowatt@gmail.com.
2
Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Edgbaston, B15 2WB, United Kingdom.
3
Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Edgbaston, B15 2WB, United Kingdom. Electronic address: ewen.griffiths@uhb.nhs.uk.

Abstract

A best evidence topic in upper gastrointestinal surgery was written according to a structured protocol. The question addressed was whether neoadjuvant chemotherapy (CT) or chemoradiotherapy (CRT) in patients with resectable oesophageal cancer is associated with the best clinical outcome. 1115 papers were found of which 5 papers were identified to answer the clinical question including 2 randomised controlled trials (level II), 2 prospective series (level II) and one retrospective study (level III). The evidence suggests CRT significantly increases the pathological complete response rate and in some studies this is associated with a significant survival advantage. This is at the cost of an increase in peri-operative morbidity and mortality. However, both randomised studies were significantly underpowered and no standard CT or CRT regimen appears to have been used in any study. Therefore, controversy still exists as to whether neoadjuvant CT or CRT is more beneficial and this has lead to variation in practice around the globe. Two randomised controlled trials are currently underway which will hopefully answer this important clinical question.

KEYWORDS:

Neoadjuvant therapy; Oesophageal cancer

PMID:
24361472
DOI:
10.1016/j.ijsu.2013.12.005
[Indexed for MEDLINE]
Free full text
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center