KẾT QUẢ BƯỚC ĐẦU HÓA XẠ TRỊ ĐỒNG THỜI TIỀN PHẪU BỆNH NHÂN UNG THƯ THỰC QUẢN 1/3 GIỮA - DƯỚI GIAI ĐOẠN II-III TẠI BỆNH VIỆN TRUNG ƯƠNG QUÂN ĐỘI 108

Abstract

Objective: To evaluate treatment response and acute toxicities following neoadjuvant concurrent chemoradiotherapy in patients with resectable cancer of the middle or lower thoracic esophagus.

Patients and Methods: This longitudinal descriptive study, with retrospective and prospective components, included 66 patients treated at 108 Military Central Hospital between February 2022 and March 2026. Intensity-modulated radiotherapy was delivered to a total dose of 41.4 Gy in 23 fractions, with concurrent weekly paclitaxel–carboplatin. Treatment response was assessed 4–6 weeks after chemoradiotherapy. Postoperative pathological response was graded according to the Mandard classification, and acute toxicities were evaluated using the Common Terminology Criteria for Adverse Events, version 5.0.

Results: The mean age was 58.7 ± 7.4 years, and all patients were male. Weight loss of ≥5% was observed in 34.8% of patients. Tumors were located in the middle and lower thirds of the thoracic esophagus in 69.7% and 30.3% of patients, respectively. Stage II and III disease accounted for 13.6% and 86.4% of cases, respectively. Overall, 75.8% of patients completed all five planned chemotherapy cycles. Of the 66 patients treated, 54 (81.8%) underwent surgery. Among the patients who underwent surgery, a pathological complete response (pCR) was confirmed in 20 of 54 patients (37.0%), and R0 resection was achieved in 53 of 54 patients (98.1%). Grade 3–4 acute toxicities included leukopenia (22.7%), neutropenia (9.1%), and elevated liver enzymes (1.5%).

Conclusion: Neoadjuvant concurrent chemoradiotherapy achieved favorable pathological response with acceptable acute toxicity in patients with resectable esophageal cancer.