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Wolverhampton Intellectual Repository and E-Theses > Research Institutes > Research Institute in Healthcare Science > Cancer Research Group > Preoperative mitomycin, ifosfamide, and cisplatin followed by esophagectomy in squamous cell carcinoma of the esophagus: pathologic complete response induced by chemotherapy leads to long-term survival.

Please use this identifier to cite or link to this item: http://hdl.handle.net/2436/29436
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Title: Preoperative mitomycin, ifosfamide, and cisplatin followed by esophagectomy in squamous cell carcinoma of the esophagus: pathologic complete response induced by chemotherapy leads to long-term survival.
Authors: Darnton, S.J.
Archer, V.R.
Stocken, D.D.
Mulholland, P.J.
Casson, A.G.
Ferry, David R.
Citation: Journal of Clinical Oncology, 21(21): 4009-4015
Publisher: American Society of Clinical Oncology
Journal: Journal of Clinical Oncology
Issue Date: 2003
URI: http://hdl.handle.net/2436/29436
DOI: 10.1200/JCO.2003.01.236
PubMed ID: 14581424
Additional Links: http://jco.ascopubs.org/cgi/content/full/21/21/4009
http://direct.bl.uk/bld/PlaceOrder.do?UIN=139860183&ETOC=RN&from=searchengine
Abstract: PURPOSE: Squamous cell carcinoma of the esophagus remains an aggressive disease with a poor prognosis, even after curative-intent surgery. This article analyzes the impact of preoperative chemotherapy with mitomycin, ifosfamide, and cisplatin (MIC) on a cohort of 68 patients. PATIENTS AND METHODS: From 1988 to 1994, 68 patients with potentially operable squamous cell carcinoma of the esophagus were entered onto two phase II trials of neoadjuvant chemotherapy with mitomycin 6 mg/m2, ifosfamide 3 g/m2, and cisplatin 50 mg/m2 and received between two and four cycles of treatment at 3-weekly intervals. Two patients were removed from the analysis when they were found to have malignancy other than squamous cell carcinoma of the esophagus. RESULTS: Forty (61%) of 66 patients had a radiologic response to chemotherapy (18 complete responses and 22 partial responses), and 52 (79%) of 66 patients went on to have the primary tumor resected. There were nine pathologic complete responders, seven of whom remain fit and well after at least 60 months of follow-up. The overall median survival was 12.4 months (95% confidence interval, 9.6 to 18.8 months). The complete response and node-negative patients survived significantly longer than those in other categories (log-rank chi2 = 18.8; P <.001): on average 13 months longer than the node-positive or nonresected category (22.0 v 9.4 months). The toxicity of the regimen was low. CONCLUSION: MIC is an easily administered, well-tolerated, and efficacious regimen as neoadjuvant therapy for patients with squamous cell carcinoma of the esophagus. These results warrant further investigation.
Type: Article
Language: en
MeSH: Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
Carcinoma, Squamous Cell
Cisplatin
Cohort Studies
Combined Modality Therapy
Drug Administration Schedule
Esophageal Neoplasms
Esophagectomy
Female
Humans
Ifosfamide
Male
Middle Aged
Mitomycin
Neoadjuvant Therapy
Neoplasm Recurrence, Local
Northern Ireland
Survival Analysis
Treatment Outcome
ISSN: 0732-183X
Appears in Collections: Cancer Research Group

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