What to Expect from the Neoadjuvant Therapy of the Oesophageal Carcinoma?
Král V.±, Neoral Č.±, Aujeský R.±, Havlík R.±, Klein J.±, Hajdúch M.*, Beneš P.+, Vrba R.±
±1. chirurgická klinika LF UP a FN v Olomouci *Laboratoř experimentální medicíny LF UP a FN v Olomouci +Onkologická klinika LF UP a FN v Olomouci |
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Summary:
Aim: The aim of this study was to assess the neoadjuvant therapy of the oesophageal carcinoma firstly from
the perspective of the immediate effect on the resection procedure itself and, secondly, from the perspective of
the long-term results.
Methodology: Prior to the resection of the oesophagus, the patients were administered the neoadjuvant
therapy. The patients were allocated to three groups with the following branches of the cytostatic treatment:
CDDP+FU, TAX+FU a CDDP. A smaller group with a less advanced disorder was treated only surgically, with
the oesophageal resection. Furthermore, the study aimed at assessing chemoresistance of the tumors according
to the MTT test and at correcting the individual branches appropriately.
Results: The total of 70 patients were operated from 2001 to V/2004. Out of this number, 15 oesophgeal
resections without the neoadjuvant therapy were conducted. None of the patients exited, and fistules were the
commonest complications.
Conclusion: No differences in postoperative complications were reported between the groups with or without
the neodjuvant therapy. Therefore, this therapy has no positive effect on the resection results themselves. The
MTT test proved to be of low significance in the neodjuvant therapy assessment. Chemoresistance can be assessed
only retrospectively and, furthermore, the results are likely to be affected by a relatively high sensitivity to the
neodjuvant therapy itself. The pCR rate reaches 20%. Long-term results had not been assessed due to a short
follow-up period.
Key words:
oesophageal carcinoma – neoadjuvant therapy
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