Comparison of Pulmonary Function Changes Between Patients Receiving Neoadjuvant Chemotherapy and Chemoradiotherapy Prior to Minimally Invasive Esophagectomy: A Randomized and Controlled Trial

Authors

Xiaosang Chen
Mingjun Du
Han Tang
Hao Wang
Yong Fang
Miao Lin
Jun Yin
Lijie Tan
Yaxing Shen

Publication Date

11-1-2022

Journal

Langenbeck's Archives of Surgery

Abstract

PURPOSE: Adequate pulmonary function is important for patients undergoing surgical resection of esophageal cancer, especially those that received neoadjuvant therapy. However, it is unknown if pre-operative radiation affects pulmonary function differently compared to chemotherapy. The purpose of this study was to compare changes in pulmonary function between patients undergoing minimally invasive esophagectomy (MIE) who received neoadjuvant chemotherapy or chemoradiotherapy.

METHODS: Between March 2017 and March 2018, esophageal cancer patients requiring neoadjuvant therapy were prospectively enrolled and randomly assigned to receive chemotherapy (CT) or chemoradiotherapy (CRT) before MIE. All patients received pulmonary function testing before and after the neoadjuvant therapy. Changes in pulmonary function, operative data, and pulmonary complications were compared between the 2 groups.

RESULTS: A total of 71 patients were randomized and underwent MIE after receiving CT (n = 34) or CRT (n = 37). Baseline clinical characteristics were comparable between the 2 groups. The CRT group experienced a greater decrease of forced expiratory volume at 1 s (FEV

CONCLUSIONS: Preoperative CRT affects pulmonary function more than CT alone, but does not increase the risk of pulmonary complications in patients undergoing MIE.

Keywords

Humans, Esophagectomy, Neoadjuvant Therapy, Esophageal Neoplasms, Chemoradiotherapy, Lung, Esophageal cancer, Neo-adjuvant therapy, Pulmonary function

Comments

Supplementary Materials

PMID: 36006505