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Difference of Neoadjuvant Treatment for Esophageal Cancer Between Japan and Western Countries
Annals of Oncology 25 (Supplement 5): v38, 2014 doi:10.1093/annonc/mdu429.1
Workshop 7: ‘The new strategy of multimodal treatment for esophageal cancer’ 1
DIFFERENCE OF NEOADJUVANT TREATMENT FOR ESOPHAGEAL CANCER BETWEEN JAPAN AND WESTERN COUNTRIES
Yoshitaka Honma, Ken Kato, Hirokazu Syoji, Natsuko Okita, Atsuo Takashima, Satoru Iwasa, Tetsuya Hamaguchi, Yasuhide Yamada, Yasuhiro Shimada Gastrointestinal Medical Oncology Division, National Cancer Center Hospital
abstracts
Surgery is a major modality in the treatment of esophageal cancer in Japan. In 1980s, radical esophageal cancer surgery, transthoracic esophagectomy with extensive lymphadenectomy, had been established as a standard procedure. In order to improve the survival, a number of studies have been carried out on adjuvant therapy. In 1990s, JCOG9204 was initiated to determine whether postoperative chemotherapy
© The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: [email protected].
Downloaded from https://academic.oup.com/annonc/article-abstract/25/suppl_5/v38/2237184 by guest on 25 October 2019
WS7
using cisplatin and 5-fluorouracil (CF) had an additive effect on survival and in patients undergoing radical surgery for locally advanced esophageal squamous cell carcinoma (LAESCC). On the basis of these data, postoperative adjuvant CF came to be the standard treatment for LAESCC in the early 2000s. In 2000s, JCOG9907 was initiated to determine the optimal perioperative timing of chemotherapy for LAESCC, that is, pre or post surgery. PFS, the primary endpoint, did not reach the stopping boundary, but OS in the pre group was superior to that in the post group. Therefore, early publication was recommended. Based on these results, preoperative CF came to be regarded as the standard treatment for patients with LAESCC. On the other hand, in Western countries, preoperative chemoradiotherapy followed by surgery is regarded as a standard care for advanced esophageal cancer from the results of CALGB9781 trial, CROSS trial, meta-analyses, and so on. However, at the present time, it is difficult to adapt the treatment of Western country to clinical practice in Japan, because there are a lot of differences in the aspects of tumor biology or surgical procedure between the Western countries and Japan. From December 2012, JCOG1109, a phase III trial comparing three preoperative treatment (CF, CF plus docetaxel (DCF), and CF plus radiotherapy) for LAESCC, have been initiated. Many oncologists in Western country, not only in Japan, pay a lot of attention for this trial, because it is possible to compare the standard preoperative treatment between Japan and Western countries.
Workshop 7: ‘The new strategy of multimodal treatment for esophageal cancer’ 1
DIFFERENCE OF NEOADJUVANT TREATMENT FOR ESOPHAGEAL CANCER BETWEEN JAPAN AND WESTERN COUNTRIES
Yoshitaka Honma, Ken Kato, Hirokazu Syoji, Natsuko Okita, Atsuo Takashima, Satoru Iwasa, Tetsuya Hamaguchi, Yasuhide Yamada, Yasuhiro Shimada Gastrointestinal Medical Oncology Division, National Cancer Center Hospital
abstracts
Surgery is a major modality in the treatment of esophageal cancer in Japan. In 1980s, radical esophageal cancer surgery, transthoracic esophagectomy with extensive lymphadenectomy, had been established as a standard procedure. In order to improve the survival, a number of studies have been carried out on adjuvant therapy. In 1990s, JCOG9204 was initiated to determine whether postoperative chemotherapy
© The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: [email protected].
Downloaded from https://academic.oup.com/annonc/article-abstract/25/suppl_5/v38/2237184 by guest on 25 October 2019
WS7
using cisplatin and 5-fluorouracil (CF) had an additive effect on survival and in patients undergoing radical surgery for locally advanced esophageal squamous cell carcinoma (LAESCC). On the basis of these data, postoperative adjuvant CF came to be the standard treatment for LAESCC in the early 2000s. In 2000s, JCOG9907 was initiated to determine the optimal perioperative timing of chemotherapy for LAESCC, that is, pre or post surgery. PFS, the primary endpoint, did not reach the stopping boundary, but OS in the pre group was superior to that in the post group. Therefore, early publication was recommended. Based on these results, preoperative CF came to be regarded as the standard treatment for patients with LAESCC. On the other hand, in Western countries, preoperative chemoradiotherapy followed by surgery is regarded as a standard care for advanced esophageal cancer from the results of CALGB9781 trial, CROSS trial, meta-analyses, and so on. However, at the present time, it is difficult to adapt the treatment of Western country to clinical practice in Japan, because there are a lot of differences in the aspects of tumor biology or surgical procedure between the Western countries and Japan. From December 2012, JCOG1109, a phase III trial comparing three preoperative treatment (CF, CF plus docetaxel (DCF), and CF plus radiotherapy) for LAESCC, have been initiated. Many oncologists in Western country, not only in Japan, pay a lot of attention for this trial, because it is possible to compare the standard preoperative treatment between Japan and Western countries.