Neoadjuvant chemoradiotherapy for resectable oesophageal cancer. (October 2018)

• Record Type: Journal Article
• Authors: Eyck, B.M.; van der Wilk, B.J.; Lagarde, S.M.; Wijnhoven, B.P.L.; Valkema, R.; Spaander, M.C.W.; Nuyttens, J.J.M.E.; van der Gaast, A.; van Lanschot, J.J.B.
• Is Part Of: Best practice & research. Volume 36/37(2018)
• Page Start: 37
• Page End: 44
• Publication Date: 2018-10
• Subjects: Chemoradiotherapy -- Chemotherapy -- Oesophageal cancer -- Response prediction -- Response evaluation; Gastroenterology -- Periodicals; Gastrointestinal system -- Diseases -- Periodicals; Gastrointestinal Diseases; Gastroenterology; Klinische geneeskunde; Gastro-enterologie; Gastroenterology; Gastrointestinal system -- Diseases; Periodicals; 616.33005
• DOI: 10.1016/j.bpg.2018.11.007
• Languages: English
• ISSNs: 1521-6918

Abstract

Abstract: At present, treatment of potentially curable oesophageal cancer includes neoadjuvant chemoradiotherapy followed by oesophagectomy. Alternatively, neoadjuvant chemotherapy is used. To date, strong evidence on the superiority of one modality over the other has not been provided. Currently, up to one-third of patients show a pathologically complete response after neoadjuvant chemoradiotherapy. To optimise the efficacy of neoadjuvant treatment for individual patients, prediction of response to neoadjuvant treatment is highly desired. Therefore, several clinical diagnostic modalities have been investigated for early response evaluation, of which positron emission tomography (PET) has been studied most extensively. To identify patients who might benefit from postponing or even omitting surgery, recent advances have been made in evaluating response after completion of neoadjuvant chemoradiotherapy. This review provides an overview of current evidence and recent advances in neoadjuvant chemoradiotherapy for oesophageal cancer and discusses the use of neoadjuvant chemotherapy compared to chemoradiotherapy. Moreover, clinical response evaluation to neoadjuvant chemoradiotherapy is reviewed.