1. Induction Chemotherapy Plus Neoadjuvant Chemoradiation for Esophageal and Gastroesophageal Junction Adenocarcinoma
- Author
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Karyn A. Goodman, Felix Ho, Tracey E. Schefter, Michael J. Weyant, John D. Mitchell, Robert J. Torphy, Sunnie Kim, Sachin Wani, Stephen Leong, Chloe Friedman, Robert A. Meguid, Christopher D Scott, Martin D. McCarter, and Ana Gleisner
- Subjects
Oncology ,medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,Gastroesophageal Junction Adenocarcinoma ,Adenocarcinoma ,Article ,03 medical and health sciences ,0302 clinical medicine ,Surgical oncology ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Chemotherapy ,business.industry ,Cancer ,Induction chemotherapy ,Chemoradiotherapy ,Induction Chemotherapy ,medicine.disease ,Neoadjuvant Therapy ,Radiation therapy ,Esophagectomy ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Surgery ,Esophagogastric Junction ,business - Abstract
BACKGROUND: Neoadjuvant chemotherapy with concurrent radiotherapy (nCRT) is an accepted treatment regimen for patients with potentially curable esophageal and gastroesophageal junction (GEJ) adenocarcinoma. The purpose of this study was to evaluate if induction chemotherapy (IC) before nCRT is associated with improved pathologic complete response (pCR) and overall survival (OS) when compared with patients who received nCRT alone for esophageal and GEJ adenocarcinoma. METHODS: Using the National Cancer Database (NCDB), patients who received nCRT and curative intent esophagectomy for esophageal or GEJ adenocarcinoma from 2006–2015 were included. Chemotherapy and radiation therapy start dates were used to define cohorts who received IC before nCRT (IC + nCRT) versus those who only received concurrent nCRT before surgery. Propensity weighting was conducted to balance patient, disease, and facility covariates between groups. RESULTS: 12,460 patients met inclusion criteria. 11,880 (95%) patients received nCRT and 580 (5%) patients received IC + nCRT. Following propensity weighting, OS was significantly improved among patients who received IC + nCRT versus nCRT (HR 0.82; 95% CI 0.74–0.92; p
- Published
- 2020