Kranzfelder et al. Br J Surg 2011 | Metaanlysis Nine RCTs involving neoadjuvant CRT versus surgery, eight involving neoadjuvant chemotherapy versus surgery, and three involving neoadjuvant treatment followed by surgery or surgery alone versus dCRT | Neoad. RChT: Sign. OS-Benefit (HR 0,81) Neoadj. ChT: No OS-Benefit (HR 0,93, p = 0,36) No OS difference after dCRT demonstrated a significant survival benefit, but treatment-related mortality rates were lower (HR 7·60, P = 0·007) than with neoadjuvant treatment followed by surgery or surgery alone. |
Stahl et al. JCO 2005 | Phase III-Study (1994–2002, 189 Pat.) CRT: 40 Gy + Cisplatin/Etoposid vs. def. RCHT | adding surgery to chemoradiotherapy improves local tumor control but does not increase survival of patients with locally advanced esophageal SCC. Tumor response to induction chemotherapy identifies a favorable prognostic group within these high-risk patients, regardless of the treatment group. |
FFCD 9102 Bedenne et al. JCO 2007 | Phase III-Study (1993–2000, 259 Pat.) T3 N0–1, 89% SCC Neoadj. CRT: Split course 30 Gy in 3 Gy or 45 Gy in 1,8 Gy + 2x Cisplatin/5-FU Random.: OP vs. def. CRT | two-year survival rate was 34% in arm A versus 40% in arm B (hazard ratio for arm B v arm A = 0.90; adjusted P = .44). Median survival time was 17.7 months in arm A compared with 19.3 months in arm B Author conclusion: there is no benefit for the addition of surgery after chemoradiation compared with the continuation of additional chemoradiation |