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.

2.50
Hdl Handle:
http://hdl.handle.net/2436/29436
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.
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.
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
Type:
Article
Language:
en
ISSN:
0732-183X
Appears in Collections:
Cancer Research Group

Full metadata record

DC FieldValue Language
dc.contributor.authorDarnton, S.J.-
dc.contributor.authorArcher, V.R.-
dc.contributor.authorStocken, D.D.-
dc.contributor.authorMulholland, P.J.-
dc.contributor.authorCasson, A.G.-
dc.contributor.authorFerry, David R.-
dc.date.accessioned2008-06-04T09:15:38Z-
dc.date.available2008-06-04T09:15:38Z-
dc.date.issued2003-
dc.identifier.citationJournal of Clinical Oncology, 21(21): 4009-4015en
dc.identifier.issn0732-183X-
dc.identifier.pmid14581424-
dc.identifier.doi10.1200/JCO.2003.01.236-
dc.identifier.urihttp://hdl.handle.net/2436/29436-
dc.description.abstractPURPOSE: 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.en
dc.language.isoenen
dc.publisherAmerican Society of Clinical Oncologyen
dc.relation.urlhttp://jco.ascopubs.org/cgi/content/full/21/21/4009en
dc.relation.urlhttp://direct.bl.uk/bld/PlaceOrder.do?UIN=139860183&ETOC=RN&from=searchengine-
dc.subject.meshAdulten
dc.subject.meshAgeden
dc.subject.meshAntineoplastic Combined Chemotherapy Protocolsen
dc.subject.meshCarcinoma, Squamous Cellen
dc.subject.meshCisplatinen
dc.subject.meshCohort Studiesen
dc.subject.meshCombined Modality Therapyen
dc.subject.meshDrug Administration Scheduleen
dc.subject.meshEsophageal Neoplasmsen
dc.subject.meshEsophagectomyen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshIfosfamideen
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshMitomycinen
dc.subject.meshNeoadjuvant Therapyen
dc.subject.meshNeoplasm Recurrence, Localen
dc.subject.meshNorthern Irelanden
dc.subject.meshSurvival Analysisen
dc.subject.meshTreatment Outcomeen
dc.titlePreoperative 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.en
dc.typeArticleen
dc.identifier.journalJournal of Clinical Oncologyen

Related articles on PubMed

All Items in WIRE are protected by copyright, with all rights reserved, unless otherwise indicated.