Concurrent Neoadjuvant Chemoradiotherapy for Siewert II and III Adenocarcinoma at Gastroesophageal Junction
Published on Jun 1, 2015in The American Journal of the Medical Sciences2.378
· DOI :10.1097/MAJ.0000000000000476
Abstract Objective This study was conducted to investigate the efficacy and safety of using a concurrent neoadjuvant chemoradiotherapy (a XELOX regimen) to treat adenocarcinoma of the gastroesophageal junction. Methods Seventy-six patients having resectable adenocarcinoma at the gastroesophageal junction (T3/4, N+, M0) were recruited to participate and randomly assigned to either a chemoradiotherapy group or a surgery group. Patients in the chemoradiotherapy group were orally given capecitabine (1,000mg/m 2 , twice daily for 14 days, days 1–14) and intravenous oxaliplatin (130mg/m 2 on day 1) for 2 cycles. Radiotherapy was performed with a total of 45Gy administered in 25 sessions for 5 weeks. Patients in the surgery group received only surgical intervention. Results In the concurrent chemoradiotherapy group, the overall response rate was 55.6% (20/36), tumor control rate was 100% and a pathological complete response was achieved in 16.7% (6/36). The entire chemoradiotherapy group had R0 resections as did 80% of the surgery group (32/40) ( P Conclusions Concurrent neoadjuvant chemoradiotherapy administration increased the rate of R0 resection and demonstrated favorable safety in patients with siewert ii or iii adenocarcinoma at the gastroesophageal junction. These results support the use of neoadjunctive chemoradiotherapy in the treatment of adenocarcinoma of the gastroesophageal junction.