Zheng Yan, Li Yin, Liu Xianben, Zhang Ruixiang, Wang Zongfei, Sun Haibo, Liu Shilei
Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China.
J Thorac Dis. 2017 Jan;9(1):200-204. doi: 10.21037/jtd.2017.01.44.
The survival benefits of neoadjuvant chemotherapy (NAC) for esophagus squamous cell carcinoma (ESCC) remains controversial. The surgical procedure was not well defined in NAC strategy, in past trials. The different surgical procedure and different levels of lymphadenectomy may decrease the survival benefits from NAC. The new chemotherapy regimen with paclitaxel is promising. The purpose of this study is to confirm the superiority of paclitaxel, cisplatin and McKeown esophagectomy with total two-field lymphadenectomy compared with surgery alone for ESCC.
A two-arm phase III trial was launched in June 2015. A total of 528 patients will be recruited from eight Chinese institutions within 2.5 years. The overall survival (OS) is the primary endpoint, and the secondary endpoints include disease-free survival (DFS), R0 resection rate, complication rate, perioperation mortality, days of hospitalization, quality of life (QOL), NAC response rate, pathologic response rate, toxicities of NAC, prognostic factors, predictive factors, progression-free survival (PFS), and adverse events.
The study will provide the final conclusion of NAC for ESCC in China.
NCT02442440 (https://register.clinicaltrials.gov/).
新辅助化疗(NAC)对食管鳞状细胞癌(ESCC)的生存获益仍存在争议。在过去的试验中,NAC策略中的手术程序并未明确界定。不同的手术程序和不同程度的淋巴结清扫可能会降低NAC带来的生存获益。含紫杉醇的新化疗方案前景良好。本研究的目的是证实与单纯手术相比,紫杉醇、顺铂联合McKeown食管切除术及全两野淋巴结清扫术治疗ESCC的优越性。
2015年6月启动了一项双臂III期试验。将在2.5年内从中国的8家机构招募528例患者。总生存期(OS)是主要终点,次要终点包括无病生存期(DFS)、R0切除率、并发症发生率、围手术期死亡率、住院天数、生活质量(QOL)、NAC缓解率、病理缓解率、NAC毒性、预后因素、预测因素、无进展生存期(PFS)和不良事件。
本研究将为中国ESCC的NAC提供最终结论。
NCT02442440(https://register.clinicaltrials.gov/)