Digestive Diseases Surgical Unit, Department of Surgery and Gastrocentro.
Clinical Oncology Division, Department of Internal Medicine.
Arq Bras Cir Dig. 2022 Jan 5;34(3):e1621. doi: 10.1590/0102-672020210002e1621. eCollection 2022.
Multimodal therapy with neoadjuvant chemoradiotherapy, followed by esophagectomy has offered better survival results, compared to isolated esophagectomy, in advanced esophageal cancer. In addition, patients who have a complete pathological response to neoadjuvant treatment presented greater overall survival and longer disease-free survival compared to those with incomplete response.
To compare the results of overall survival and disease-free survival among patients with complete and incomplete response, submitted to neoadjuvant chemoradiotherapy, with two therapeutic regimens, followed by transhiatal esophagectomy.
Retrospective study, approved by the Research Ethics Committee, analyzing the medical records of 56 patients with squamous cell carcinoma of the esophagus, divided into two groups, submitted to radiotherapy (5040 cGY) and chemotherapy (5-Fluorouracil + Cisplatin versus Paclitaxel + Carboplatin) neoadjuvants and subsequently to surgical treatment, in the period from 2005 to 2012, patients.
The groups did not differ significantly in terms of gender, race, age, postoperative complications, disease-free survival and overall survival. The 5-year survival rate of patients with incomplete and complete response was 18.92% and 42.10%, respectively (p> 0.05). However, patients who received Paclitaxel + Carboplatin, had better complete pathological responses to neoadjuvant, compared to 5-Fluorouracil + Cisplatin (47.37% versus 21.62% - p = 0.0473, p <0.05).
There was no statistical difference in overall survival and disease-free survival for patients who had a complete pathological response to neoadjuvant. Patients submitted to the therapeutic regimen with Paclitaxel and Carboplastin, showed a significant difference with better complete pathological response and disease progression. New parameters are indicated to clarify the real value in survival, from the complete pathological response to neoadjuvant, in esophageal cancer.
新辅助放化疗联合食管切除术治疗局部晚期食管癌较单纯手术切除可提高生存率。此外，新辅助治疗完全病理缓解的患者总生存时间和无病生存时间均长于不完全缓解的患者。
比较两种新辅助放化疗方案（顺铂+氟尿嘧啶与紫杉醇+卡铂）联合经胸食管切除术治疗后完全和不完全病理缓解的患者的总生存时间和无病生存时间。
回顾性研究，经研究伦理委员会批准，分析了 2005 年至 2012 年期间 56 例食管鳞癌患者的病历，这些患者分为两组，接受放疗（5040 cGY）和化疗（顺铂+氟尿嘧啶或紫杉醇+卡铂）新辅助治疗，然后接受手术治疗。
两组患者在性别、种族、年龄、术后并发症、无病生存时间和总生存时间方面无显著差异。不完全和完全病理缓解患者的 5 年生存率分别为 18.92%和 42.10%（p>0.05）。然而，与顺铂+氟尿嘧啶相比，接受紫杉醇+卡铂新辅助治疗的患者完全病理缓解率更高（47.37%比 21.62%，p=0.0473，p<0.05）。
新辅助治疗完全病理缓解的患者在总生存时间和无病生存时间方面无统计学差异。接受紫杉醇+卡铂治疗方案的患者，完全病理缓解率和疾病进展率差异有统计学意义。需要新的参数来明确新辅助治疗完全病理缓解对食管癌患者生存的实际价值。
