Association between radiation dose and pathological complete response after preoperative radiochemotherapy in esophageal XXXX .

@entity1 @entity901 @entity41 @entity1544 @entity418 @entity1349 @entity1487
AIM: This study was undertaken to examine the impact of radiation dose on pathological complete response (pCR) rates following neoadjuvant radiochemotherapy (N-RCT) for @entity1544 ( @entity418 ). @entity1 AND METHODS: From 1988 to 2011, 218 @entity1 were treated with 30-30.6 Gy (1.8-2 Gy per fraction), 39.6-40 Gy (1.8-2 Gy per fraction) or 44-45 Gy (1.8-2 Gy per fraction) and concomitant cisplatin    5-fluorouracil ( @entity1487 ), @entity901 + @entity1487 or @entity1487 alone. The most commonly used concomitant chemotherapy was continuous infusion of @entity1487 -alone with a dose of 300 mg/m(2)/day during the whole course of treatment (n=111). To eliminate the dispersing effect of potentially different efficacy levels of these drug regimens on pCR, we excluded @entity1 with regimens other than @entity1487 -alone. RESULTS: Histomorphological regression grade 1a (0% @entity41 ), 1b (<10% @entity41 ), 2 (10-50% @entity41 ) and 3 (>50% @entity41 ) was observed in 26 (23%), 24 (22%), 36 (32%) and 25 (23%) @entity1 , respectively. pCR was observed in 9 out of 71 (13%) @entity1 treated with 30 Gy-30.6 Gy, 13 of 34 (38%) @entity1 treated with 39.6-40 Gy and 4 of 6 (67%) @entity1 treated with 44-45 Gy (p=0.001). Median follow-up time from the start of N-RCT was 191 months (range=2-262 months). The estimated 5-year @entity1349 ( @entity1349 ) was 33% for the whole cohort. @entity1349 at 5 years was 58% for @entity1 with pCR compared to 25% for @entity1 with less favorable response to N-RCT (p=0.009), respectively. CONCLUSION: The dose of radiation correlates significantly with the likelihood of achieving a pCR in stage II/III @entity1544 @entity1 . Prospective randomized trials are required to definitively evaluate the impact of application of higher radiation doses on efficacy and safety/tolerability in the context of N-RCT on the clinical outcomes.
