S.G. Afanasyev, A.Yu. Dobrodeev, Yu.B. Urmonov, O.V. Cheremisina
Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk
Afanasyev S.G. ― D. Sc. (Medicine), Professor, Head of the Department of Abdominal Oncology of Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences
5 Kooperativny Lane, Tomsk, Russian Federation, 634009, tel. (3822) 41-80-89, e-mail: Afanasievsg@oncology.tomsk.ru, SPIN-код: 9206-3037, ORCID ID: 0000-0002-4701-0375
Background. Long-term outcomes after surgical treatment of esophageal cancer still remain poor, therefore multimodal approach including neoadjuvant chemotherapy and surgery is promising.
Material and methods. The study included 40 patients with stage II-III esophageal cancer. The patients were divided into 2 groups. Group I (study group) consisted of 20 patients, who received 2 courses of neoadjuvant chemotherapy (gemcitabine + cisplatin) followed by radical surgery. Group II comprised 20 patients, who underwent surgery alone.
Results. Among the patients who received neoadjuvant chemotherapy, complete tumor regression was observed in 1 (5%) patient, partial regression in 8 (40%) patients and stable disease in 9 (45%) patients. Treatment was well tolerated with low toxicity. Restoration of enteral nutrition was observed in most patients. Postoperative complications in Group I and II patients occurred in 20% and 25%, respectively (p>0.05). Two-year overall and disease-free survival rates were significantly higher in esophageal cancer patients, who received combined modality treatment including neoadjuvant chemotherapy than in the control group patients, who underwent surgery alone (84.2±8.2 and 84.2±8.2% versus 63.2±11.1 and 42.1±11.4 %, respectively (р<0.05).
Conclusion. Neoadjuvant chemotherapy with gemcitabine and cisplatin showed high immediate response. Multimodal approach to the treatment of stage II-III esophageal cancer led to a significant increase in 2-year overall survival due to effective local control and prevention of distant metastasis.
Key words: squamous esophageal cancer, combined modality treatment, neoadjuvant chemotherapy, short-and long-term treatment outcomes.