Preliminary results of a phase III randomized study comparing chemotherapy neoadjuvantly or concurrently with radiotherapy for locoregionally advanced XXXX .

@entity1 @entity137 @entity66 @entity1614 @entity900 @entity33 @entity189 @entity391 @entity1487
The current study was conducted to compare neoadjuvant chemotherapy (NACT) with concurrent chemotherapy for efficacy, @entity137 and compliance of locoregionally advanced @entity189 ( @entity189 ). Eligible @entity1 were randomized to NACT + radiotherapy (RT) + adjuvant chemotherapy (AC) arm or concurrent chemoradiotherapy(CCRT) + AC arm. Two arms received same conventional RT at a planned dose of 70 Gy. Neoadjuvant chemotherapy comprised @entity900 90 mg/m(2) (30 mg/m(2)/day) and @entity1487 1,500 mg/m(2) (500 mg/m(2)/day) over 3 days for two 21-day cycles. The same regimen at equal dosage was administered on the 1st and 22nd days of the radiotherapy as concurrent chemotherapy. Four cycles of the same chemotherapy regimen were given to both two arms as AC. A total of 338 @entity189 @entity1 were recruited. 170 @entity1 were randomized to NACT arm and 168 @entity1 to CCRT arm. The median duration of follow-up was 38 months. The 3-year OS and DFS rates were 95.9 versus 94.5% (P = 0.54) and 78.5 versus 82.5% (P = 0.16), respectively, in NACT and CCRT arms. An unplanned subgroup analysis according to the N-classification suggested that CCRT improves @entity1614 in @entity1 with N0-1 disease (80.1 vs. 94.9%, P = 0.034). Among the acute @entity137 observed, the rates of grade 3/4 @entity33 (52.4 vs. 35.9% P = 0.023) and @entity391 (13.7 vs. 4.7% P = 0.000) were significantly higher in CCRT arm. Our preliminary results only showed an advantage of CCRT over NACT in @entity189 @entity1 with @entity66 in @entity1614 . More acute @entity137 were observed in CCRT arm and a trend of better tolerance was observed in NACT arm.
