AUTHOR=Tian Yuan , Wang Jun , Qiao Xueying , Zhang Jun , Li Yong , Fan Liqiao , Zhang Zhidong , Zhao Xuefeng , Tan Bibo , Wang Dong , Yang Peigang , Zhao Qun 

TITLE=Long-Term Efficacy of Neoadjuvant Concurrent Chemoradiotherapy for Potentially Resectable Advanced Siewert Type II and III Adenocarcinomas of the Esophagogastric Junction

JOURNAL=Frontiers in Oncology

VOLUME=11

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.756440

DOI=10.3389/fonc.2021.756440

ISSN=2234-943X

ABSTRACT=<sec><title>Background</title><p>Reports have shown that neoadjuvant concurrent chemoradiotherapy (nCRT) increases the R0 resection rate for patients with Siewert type II or III adenocarcinoma of the gastroesophageal junction (AEG). However, the long-term efficacy of nCRT for AEG patients remains unclear. In this multicenter study, we investigated the long-term results of AEG patients treated with nCRT.</p></sec><sec><title>Methods</title><p>A total of 149 patients with potentially resectable advanced AEG (T3/4, Nany, M0) were randomly divided into two groups: the nCRT-treated group (treated group) (<italic>n</italic> = 76) and the surgery group (control group) (<italic>n</italic> = 73). The primary endpoint was disease-free survival (DFS), and the secondary outcome indexes included the R0 resection rate, HER-2 expression, tumor regression grade (TRG), objective response rate (ORR), disease control rate (DCR), overall survival (OS), and adverse events.</p></sec><sec><title>Results</title><p>In the treated group, the overall therapeutic efficacy rate was 40.8%, and the pathological complete response (pCR) rate was 16.9%. The rates of patients who underwent R0 resection in the treated and control groups were 97.0% and 87.7%, respectively (<italic>p</italic> &lt; 0.05). The toxic effects were mainly graded 1–2 in the treated group. The median DFS times in the treated and control groups were 33 and 27 months, respectively (<italic>p</italic> = 0.08), whereas the median OS times were 39 and 30 months, respectively (<italic>p</italic> = 0.01). The median DFS times of patients with positive and negative HER-2 expression in the treated group were 13 and 43 months, respectively (<italic>p</italic> = 0.01), and the median OS times were 27 and 41 months, respectively (<italic>p</italic> = 0.01).</p></sec><sec><title>Conclusion</title><p>Surgery after nCRT improved the efficacy of treatment for AEG patients and thus provided a better prognosis.</p></sec><sec><title>Clinical Trial Registration</title><p>The trial is registered with <uri xlink:href="https://clinicaltrials.gov/" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrials.gov</uri> (number NCT01962246).</p></sec>