Impact of tumour histological subtype on chemotherapy outcome in advanced oesophageal cancer

• 作者: Michael Davidson Ian Chau David Cunningham Komel Khabra Timothy Iveson Tamas Hickish Matthew Seymour Naureen Starling
• 来源期刊: 世界胃肠肿瘤学杂志：英文版（电子版）
• 学科: 医学
• 关键词: 食道的癌症 腺癌 化疗 有鳞 分享的分析
• 年，卷（期）: 2017,（8）
• 页码范围: 333-340
• 页数: 8页
• 分类号: R735.1

摘要

AIM To investigate the impact of histology on outcome in advanced oesophageal cancer treated with first-line fluoropyrimidine-based chemotherapy.METHODS Individual patient data were pooled from three randomised phase Ⅲ trials of fluoropyrimidine-based chemotherapy ± platinum/anthracycline in patients with advanced, untreated gastroesophageal adenocarcinoma or squamous cell carcinoma(SCC) randomised between 1994 and 2005. The primary endpoint was overall survival of oesophageal cancer patients according to histology. Secondary endpoints were response rates and a toxicity composite endpoint.RESULTS Of the total 1836 randomised patients, 973 patients(53%)were eligible(707 patients with gastric cancer were excluded), 841(86%) had adenocarcinoma and 132(14%) had SCC. There was no significant difference in survival between patients with adenocarcinoma and SCC, with median overall survivals of 9.5 mo vs 7.6 mo(HR = 0.85, 95%CI: 0.70-1.03, P = 0.09) and one-year survivals of 38.8% vs 28.2% respectively. The overall response rate to chemotherapy was 44% for adenocarcinoma vs 33% for SCC(P = 0.01). There was no difference in the frequency of the toxicity composite endpoint between the two groups. CONCLUSION There was no significant difference in survival between adenocarcinoma and SCC in patients with advanced oesophageal cancer treated with fluoropyrimidine-based chemotherapy despite a trend for worse survival and less chemo-sensitivity in SCC. Tolerance to treatment was similar in both groups. This analysis highlights the unmet need for SCC-specific studies in advanced oesophageal cancer and will aid in the design of future trials of targeted agents.