|Table of Contents|

Analysis of the short-term efficacy of preoperative neoadjuvant therapy for stage Ⅲ adenocarcinoma of the esophagogastric junction

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 01
Page:
109-114
Research Field:
Publishing date:

Info

Title:
Analysis of the short-term efficacy of preoperative neoadjuvant therapy for stage Ⅲ adenocarcinoma of the esophagogastric junction
Author(s):
PENG Tao1; LOU Zhan2; CAO Mingfu3; WANG Xiaoyuan3; HUANG Di3; ZHANG Guiyun1; GAO Huibin1; LI Shuguang3
1.Endoscopic Room;2.Department of Neurology;3.Department of Gastrointestinal Cancer Surgery,the First Affiliated Hospital of Hebei North University,Hebei Zhangjiakou 075000,China.
Keywords:
neoadjuvant chemotherapy; neoadjuvant chemoradiotherapy; paclitaxel; carboplatin; adenocarcinoma of esophagogastric junction
PACS:
R735.2
DOI:
10.3969/j.issn.1672-4992.2023.01.020
Abstract:
Objective:To investigate the application of preoperative neoadjuvant chemotherapy regimen of paclitaxel plus carboplation(TC) for single week,preoperative TC for single week combined with radiotherapy and direct surgery in the treatment of stage Ⅲ adenocarcinoma of esophagogastric junction(AEG),and to evaluate the imaging changes and short-term efficacy of preoperative neoadjuvant therapy in stage Ⅲ AEG treatment.Methods:90 patients with stage III AEG were randomly divided into direct surgery group,TC regimen neoadjuvant chemotherapy group,and TC regimen neoadjuvant chemotherapy combined with radiotherapy group,30 cases in each group.The imaging changes in the neoadjuvant chemotherapy group and the neoadjuvant chemoradiotherapy group were evaluated,and the clinical and pathological staging changes in the neoadjuvant chemotherapy group and the neoadjuvant chemoradiotherapy group were compared,and the surgical R0 resection rate was compared among the three groups.Results:Imaging changes after neoadjuvant therapy for electronic gastroscope showed tumors in neoadjuvant chemotherapy group and chemoradiotherapy group shrunk or disappeared,and the mucosa at some primary lesions was smoother than before,slightly congested and turned red.CT examination showed that the primary tumor foci was significantly reduced.The infiltrating gastric wall was thinner than before,and the structure level was clearer than before,and the surrounding lymph nodes were smaller and/or less in number than before.Imaging suggested that neoadjuvant therapy has a significant effect on AEG treatment.Staging changes after neoadjuvant therapy was showed the neoadjuvant chemoradiotherapy group had significant staging changes compared with the neoadjuvant chemotherapy group,and the difference was statistically significant(P＜0.05).The R0 resection rate of the three groups:the R0 resection rate of the neoadjuvant chemotherapy group and the neoadjuvant chemoradiotherapy group was higher than that of the direct surgery group(Pa=0.004,Pb=0.000),and the R0 resection rate of the neoadjuvant chemotherapy group was higher than that of the neoadjuvant chemoradiotherapy group.Adjuvant chemotherapy group(Pc=0.045).Conclusion:TC single-week neoadjuvant chemotherapy and neoadjuvant concurrent chemoradiotherapy can both significantly change the imaging lesions of stage III AEG patients,have downstage tumor lesions,and improve R0 resection rate.The effect of neoadjuvant concurrent chemoradiotherapy group is better than that of neoadjuvant chemotherapy group.TC single-week neoadjuvant chemotherapy combined with concurrent radiotherapy can be promoted for the neoadjuvant treatment of stage Ⅲ AEG.

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Memo:
河北省张家口市科技计划项目（编号：2021078D）；河北省政府资助临床医学优秀人才培养和基础课题研究项目（编号：361009）
Last Update: 2022-11-30