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- W4297216536 abstract "Abstract Treatment options for esophageal cancer (EC) have rapidly expanded from surgery alone to multimodal approaches comprising surgery, chemotherapy or radiotherapy. High-quality evidence from clinical trials indicated that both carboplatin/paclitaxel (CROSS) and cisplatin/5-fluorouracil (PF) regimens are significantly effective at improving survival. However, the most beneficial neoadjuvant chemoradiotherapy (nCRT) combination for esophageal squamous cell carcinoma (ESCC) in Asia still remains uncertain. In this study we compared neoadjuvant CROSS versus PF regimen in combination with 41.4-50.4Gy of radiotherapy. Patients with ESCC were enrolled from three asian medical centers and stratified according to their nCRT regimen, i.e., CROSS+41.4-45Gy (CROSS) versus PF + 45Gy (PF4500) versus PF + 50.4Gy (PF5040). Propensity score analyses with stratification by inverse probability of treatment weighting (IPTW) was applied for nine baseline variables: gender, age, Charlson’s comorbidity index, clinical T and N stages, clinical stage, tumor length, tumor level and year of nCRT. Primary and secondary endpoints included overall survival (OS) and treatment-related complications. Compared to CROSS, patients who received PF regimens were expected to achieve comparable OS albeit more treatment-related complications. Before IPTW, 334 patients were included (CROSS, n = 124 versus PF4500, n = 105 versus PF5040, n = 105). The lowest chemotherapy completion rate was observed in the PF5040 group (76.2% versus 89.4% in CROSS and 92% in the PF4500 group). Compared with CROSS, both PF groups showed more severe weight loss during nCRT and a higher frequency of post-esophagectomy anastomotic leaks. PF5040 had the significantly highest pCR rate (45.3%). CROSS conferred a significant OS benefit over PF4500 (hazard ratio [HR] =1.30, 95% CI = 1.05-1.62) and similar survival compared with PF5040 (HR = 1.17, 95% CI = 0.94-1.45). The same trends were found upon analysing recurrence free survival. (Figure). Prior investigations reporting on the safety and efficacy of CROSS are mainly conducted in western populations, generally consisting adenocarcinoma, limiting the generalisability of these findings to Asian patients with ESCC. In our study, the CROSS regimen conferred a significant survival benefit over PF4500 and similar survival figures compared with PF5040. Considering the lower incidences of severe weight loss and post-esophagectomy anastomotic leaks, CROSS represents a safe and effective neoadjuvant treatment in Asian patients with ESCC." @default.
- W4297216536 created "2022-09-28" @default.
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- W4297216536 date "2022-09-01" @default.
- W4297216536 modified "2023-09-27" @default.
- W4297216536 title "377. NEOADJUVANT CARBOPLATIN/PACLITAXEL VERSUS 5-FLUOROURACIL/CISPLATIN IN COMBINATION WITH RADIOTHERAPY FOR ESOPHAGEAL SQUAMOUS CELL CARCINOMA: A MULTICENTER COMPARATIVE STUDY" @default.
- W4297216536 doi "https://doi.org/10.1093/dote/doac051.377" @default.
- W4297216536 hasPublicationYear "2022" @default.
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