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Current Oncology
Volume 21
Issue 3
10.3747/co.21.1570
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
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Article

Effect of Preoperative Chemoradiotherapy on Outcome of Patients with Locally Advanced Esophagogastric Junction Adenocarcinoma—A Pilot Study

by
M. Orditura
1,
G. Galizia
2,
N. Di Martino
2,
E. Ancona
3,
C. Castoro
3,
R. Pacelli
4,
F. Morgillo
1,
S. Rossetti
1,
V. Gambardella
1,
A. Farella
4,
M.M. Laterza
1,
A. Ruol
3,
A. Fabozzi
1,
V. Napolitano
2,
F. Iovino
2,
E. Lieto
2,
L. Fei
2,
G. Conzo
2,
F. Ciardiello
1 and
F. De Vita
1,*
1
Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, Naples, Italy
2
Divisions of Surgical Oncology, Department of Anesthesiologic, Surgical, and Emergency Sciences, Second University of Naples School of Medicine, Naples, Italy
3
Division of General Surgery 1, University of Padua, School of Medicine, Padua, Italy
4
Division of Radiotherapy, Federico ii University of Naples School of Medicine, Naples, Italy
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2014, 21(3), 125-133; https://doi.org/10.3747/co.21.1570
Submission received: 3 March 2014 / Revised: 5 April 2014 / Accepted: 7 May 2014 / Published: 1 June 2014

Abstract

Background: To date, few studies of preoperative chemotherapy or chemoradiotherapy (crt) in gastroesophageal junction (gej) cancer have been statistically powered; indeed, gej tumours have thus far been grouped with esophageal or gastric cancer in phase iii trials, thereby generating conflicting results. Methods: We studied 41 patients affected by locally advanced Siewert type i and ii gej adenocarcinoma who were treated with a neoadjuvant crt regimen [folfox4 (leucovorin–5-fluorouracil–oxaliplatin) for 4 cycles, and concurrent computed tomography–based threedimensional conformal radiotherapy delivered using 5 daily fractions of 1.8 Gy per week for a total dose of 45 Gy], followed by surgery. Completeness of tumour resection (performed approximately 6 weeks after completion of crt), clinical and pathologic response rates, and safety and outcome of the treatment were the main endpoints of the study. Results: All 41 patients completed preoperative treatment. Combined therapy was well tolerated, with no treatment-related deaths. Dose reduction was necessary in 8 patients (19.5%). After crt, 78% of the patients showed a partial clinical response, 17% were stable, and 5% experienced disease progression. Pathology examination of surgical specimens demonstrated a 10% complete response rate. The median and mean survival times were 26 and 36 months respectively (95% confidence interval: 14 to 37 months and 30 to 41 months respectively). On multivariate analysis, TNM staging and clinical response were demonstrated to be the only independent variables related to long-term survival. Conclusions: In our experience, preoperative chemoradiotherapy with folfox4 is feasible in locally advanced gej adenocarcinoma, but shows mild efficacy, as suggested by the low rate of pathologic complete response.
Keywords: preoperative chemoradiotherapy; gastroesophageal junction cancer; folfox4 preoperative chemoradiotherapy; gastroesophageal junction cancer; folfox4

Share and Cite

MDPI and ACS Style

Orditura, M.; Galizia, G.; Di Martino, N.; Ancona, E.; Castoro, C.; Pacelli, R.; Morgillo, F.; Rossetti, S.; Gambardella, V.; Farella, A.; et al. Effect of Preoperative Chemoradiotherapy on Outcome of Patients with Locally Advanced Esophagogastric Junction Adenocarcinoma—A Pilot Study. Curr. Oncol. 2014, 21, 125-133. https://doi.org/10.3747/co.21.1570

AMA Style

Orditura M, Galizia G, Di Martino N, Ancona E, Castoro C, Pacelli R, Morgillo F, Rossetti S, Gambardella V, Farella A, et al. Effect of Preoperative Chemoradiotherapy on Outcome of Patients with Locally Advanced Esophagogastric Junction Adenocarcinoma—A Pilot Study. Current Oncology. 2014; 21(3):125-133. https://doi.org/10.3747/co.21.1570

Chicago/Turabian Style

Orditura, M., G. Galizia, N. Di Martino, E. Ancona, C. Castoro, R. Pacelli, F. Morgillo, S. Rossetti, V. Gambardella, A. Farella, and et al. 2014. "Effect of Preoperative Chemoradiotherapy on Outcome of Patients with Locally Advanced Esophagogastric Junction Adenocarcinoma—A Pilot Study" Current Oncology 21, no. 3: 125-133. https://doi.org/10.3747/co.21.1570

APA Style

Orditura, M., Galizia, G., Di Martino, N., Ancona, E., Castoro, C., Pacelli, R., Morgillo, F., Rossetti, S., Gambardella, V., Farella, A., Laterza, M. M., Ruol, A., Fabozzi, A., Napolitano, V., Iovino, F., Lieto, E., Fei, L., Conzo, G., Ciardiello, F., & De Vita, F. (2014). Effect of Preoperative Chemoradiotherapy on Outcome of Patients with Locally Advanced Esophagogastric Junction Adenocarcinoma—A Pilot Study. Current Oncology, 21(3), 125-133. https://doi.org/10.3747/co.21.1570

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