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AnnalsofOncology26:1722–1728,2015
doi:10.1093/annonc/mdv223
Publishedonline8May2015
Chemoradiation,surgeryandadjuvantchemotherapy
versusinductionchemotherapyfollowedby
chemoradiationandsurgery:long-termresults
?
oftheSpanishGCR-3phaseIIrandomizedtrial
123456
C.Fernandez-Martos,X.Garcia-Albeniz,C.Pericay,J.Maurel,J.Aparicio,C.Montagut,
7891011121314
M.J.Safont,A.Salud,R.Vera,B.Massuti,P.Escudero,V.Alonso,C.Bosch,M.Martin
15
&B.D.Minsky
12
DepartmentofMedicalOncology,ValencianInstituteofOncology,Valencia,Spain;DepartmentofEpidemiology,HarvardT.H.ChanSchoolofPublicHealth,Boston,
345
USA;DepartmentofMedicalOncology,ParcTaulíHospital,Sabadell;DepartmentofMedicalOncology,ClinicHospital,Barcelona;DepartmentofMedicalOncology,
67
LaFeUniversityHospital,Valencia;DepartmentofMedicalOncology,DelMarHospital,Barcelona;DepartmentofMedicalOncology,GeneralUniversityHospital,
8910
Valencia;DepartmentofMedicalOncology,ArnaudeVilanovaHospital,Lleida;DepartmentofMedicalOncology,NavarraHospital,Pamplona;DepartmentofMedical
1112
Oncology,GeneralHospital,Alicante;DepartmentofMedicalOncology,LozanoBlesaHospital,Zaragoza;DepartmentofMedicalOncology,MiguelServetHospital,
1314
Zaragoza;DepartmentofMedicalOncology,PessetHospital,Valencia;DepartmentofMedicalOncology,SantaCreuySantPauHospital,Barcelona,Spain;
15
DivisionofRadiationOncology,MDAndersonHospital,Houston,USA
Received18February2015;revised24April2015;accepted2May2015
Background:TheprimaryresultsofourphaseIIrandomizedtrialsuggestedthatcomparedwithconventionalpreopera-
tivechemoradiation(CRT),theadditionofchemotherapy(CT)beforeCRTandsurgeryallowsmostpatientsreceivetheir
plannedtreatmentwithabettertoxicityprolewithoutcompromisingthepathologicalcompleteresponseandcomplete
resectionrates.Wenowreportthe5-yearoutcomes.
Patientsandmethods:Patientswithdistalormiddlethird,T3–T4and/orN+rectaladenocarcinomaselectedbymag-
neticresonanceimaging,wererandomlyassignedtoarmA—preoperativeCRTfollowedbysurgeryandfourcyclesof
postoperativeadjuvantcapecitabineandoxaliplatin(CAPOX)—orarmB—fourcyclesofCAPOXfollowedbyCRTand
surgery.Thefollowing5-yearactuarialoutcomeswereassessed:thecumulativeincidenceoflocalrelapse(LR)and
distantmetastases(DM),disease-free(DFS)andoverallsurvival(OS).
Results:Atotalof108eligiblepatientswererandomlyassignedtoarmA(n=52)orarmB(n=56).Withamedian
follow-upof69.5months,5-yearDFSwas64%inarmAand62%inarmB(P=0.85)and5-yearOSwas78%inarm
Aand75%inarmB(P=0.64).The5-yearcumulativeincidenceofLRwas2%and5%(P=0.61)and5-yearcumulative
incidenceofDMwas21%and23%;(P=0.79)inarmsAandB,respectively.
Correspondenceto:DrCarlosFernández-Martos,DepartmentofMedicalOncology,
GastrointestinalOncologyUnit,ValencianInstituteofOncology,CalleGregorioGea31,
Valencia46009,Spain.Tel:+34-111-4042;Fax:+34-111-4344;E-mail:cfmartos@vo.org
?
Presentedinpartasatthe2014ASCOGastrointestinal(16–18January2014,
SanFrancisco,CA,USA).
?TheAuthor2015.PublishedbyOxfordUniversityPressonbehalfoftheEuropeanSocietyforMedicalOncology.
Allrightsreserved.Forpermissions,pleaseemail:journals.permissions@oup.com. |
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