Adjuvant versus neoadjuvant chemoradiotherapy in XXXX : Comparison of two decades in a single center.

@entity1 @entity4181 @entity5 @entity2802 @entity348 @entity420 @entity1487
OBJECTIVE: Standard surgery alone was not able to decrease local recurrence (LR) rate below 20% in @entity5 treatment. Thus, many centers administered neoadjuvant radiotherapy (preopRTx) with or without concomitant chemotherapy for the prevention of LR. In this study, the results of 164 consecutive @entity1 with mid- and @entity5 who received surgery and adjuvant chemoradiotherapy (Group A) or neoadjuvant chemoradiotherapy (Group NA) followed by surgery are presented. MATERIAL AND METHODS: The staging system used in this study is that of the American Joint Committee on Cancer (AJCC), also known as the @entity2802 system. Eligible @entity1 were required to have radiologically assessed stage 1 (only T2N0M0) to stage 3C (T4bN1-2M0) @entity5 with pathologically confirmed R0 resection. The surgical method was @entity348 ( @entity348 ). Radiotherapy was applied with daily 180 cGy fractions for 28 consecutive days. Chemo-therapy comprised @entity1487 (450 mg/m(2)/d) and @entity4181 (20 mg/m(2)/d) bolus at days 1-5 and 29-33. RESULTS: Nine @entity1 (13%) in Group NA achieved pathologic complete response (pCR). In Group NA and Group A, locoregional recurrence (LRR) rates were 6.7% and 30.8%, (p<0.001), the mean LR-free survival was 190.0  7.3 months and 148.0  11.7 months (p=0.002) and the mean overall survival (OS) was 119.2  15.3 months and 103.0  9.4 months (p=0.23), respectively. A significant difference with regard to LR has been obtained with a statistical power of 0.92. Secondary outcome measures (DFS and OS) have not been met. CONCLUSION: Neoadjuvant chemoradiotherapy with @entity348 is an efficient treatment protocol, particularly for the treatment of magnetic resonance imaging-staged 2A to 3C @entity1 with two or three @entity420 . Given that a considerable proportion of @entity1 with cT2N0M0 would develop pCR, this method of treatment can be considered for further studies.
