Shaikh Talha, Ruth Karen, Scott Walter J, Burtness Barbara A, Cohen Steven J, Konski Andre A, Cooper Harry S, Astsaturov Igor, Meyer Joshua E
Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
Ann Thorac Surg. 2015 Jan;99(1):270-6. doi: 10.1016/j.athoracsur.2014.08.033. Epub 2014 Nov 18.
The interval between neoadjuvant chemoradiation treatment and surgery has been described as an important predictor of pathologic response to therapy in nonesophageal cancer sites. We retrospectively reviewed our experience with patients who underwent neoadjuvant chemoradiation and esophagectomy to better understand the impact of the timing of surgery on pathologic complete response rates in esophageal cancer.
Two hundred thirty-one sequentially treated patients from 2000 to 2011 were identified for this study; 88 of these patients completed neoadjuvant chemoradiation followed by esophagectomy at our institution. The interval between completion of chemoradiation and surgery was calculated for each patient. The patients were categorized into quartiles and also into 3-week interval groups. Treatment factors and surgical morbidity data, including the estimated blood loss and length of operative stay, were also assessed.
Quartiles for the neoadjuvant chemoradiation to surgery interval were less than 45 days, 46 to 50 days, 51 to 63 days, and 64+ days. Corresponding pathologic complete response rates were 12.5%, 20.0%, 22.7%, and 40.9% (p = 0.03). Results for 3-week intervals were similar (p = 0.02). There was no association between increasing time interval between the ending of neoadjuvant chemoradiation to surgery and length of stay longer than 2 weeks.
A longer interval between completion of neoadjuvant chemoradiation and surgery was associated with higher pathologic complete response rates without an impact on surgical morbidity.
新辅助放化疗与手术之间的间隔时间已被描述为非食管癌部位治疗病理反应的重要预测指标。我们回顾性分析了接受新辅助放化疗及食管切除术患者的经验，以更好地了解手术时机对食管癌病理完全缓解率的影响。
本研究纳入了2000年至2011年连续治疗的231例患者；其中88例患者在我们机构完成新辅助放化疗后接受了食管切除术。计算了每位患者放化疗结束与手术之间的间隔时间。将患者分为四分位数组，也分为3周间隔组。还评估了治疗因素和手术并发症数据，包括估计失血量和住院时间。
新辅助放化疗至手术间隔的四分位数分别为少于45天、46至50天、51至63天和64天及以上。相应的病理完全缓解率分别为12.5%、20.0%、22.7%和40.9%（p = 0.03）。3周间隔的结果相似（p = 0.02）。新辅助放化疗结束至手术之间间隔时间增加与住院时间超过2周之间无关联。
新辅助放化疗完成与手术之间间隔时间延长与更高的病理完全缓解率相关，且对手术并发症无影响。
