Dalfsen, Q. van (Quirine) (2013) Het effect van (neoadjuvante) chemoradiotherapie op het ontwikkelen van trombo-embolische processen bij patiënten met een oesofaguscarcinoom. thesis, Medicine.
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Abstract
Background: Neoadjuvant chemoradiotherapy has recently been accepted as a part of standard treatment for esophageal carcinoma. This multimodality treatment offers a increased opportunity to obtain tumor negative resection margins with improved loco-regional control and increased survival. Although, esophageal cancer, chemotherapy and radiotherapy are associated with an increased incidence of thromboembolic events, the exact incidence of thromboembolic events in patients treated with (neoadjuvant) chemoradiation is still unknown. Also, the impact of chemoradiation on the development of thromboembolic events is not clear. Another issue is the impact of thromboembolic events on prognosis and survival in patients with curable intended esophageal carcinoma. Methods: We included in retrospective study 217 curative threated patients with esophageal cancer and compared the occurrences and impact of thromboembolic events in three different curative treatment models for esophageal carcinoma. One group received esophagectomy alone (group A), the second group (group B) received neoadjuvant chemoradiotherapy followed by surgical resection and the last group (group C) consisted of patients who received definitive chemoradiotherapy. In this study we determined the incidence of thromboembolic events in all these well defined groups of esophageal cancer patients. In patients who underwent surgery the incidence was scored in both the pre- and postoperative period. We also assessed whether the occurrence of thromboembolic events had impact on the prognosis and mortality in the three different patientgroups with esophageal carcinoma. Results: In the neoadjuvant chemoradiotherapy group (B), 8% of the patients developed a thromboembolic event, compared to none in the surgery alone group (A) ( p= 0.015). In the definitive chemoradiation group (C), 12% developed a tromboembolic event during chemoradiotherapy versus 8% in the neoadjuvant chemoradiotherapy group (p= 0.579). There was no significant impact of thromboembolic events on 30-day, 90-day or 1-year mortality in all groups. Conclusion: This study shows an increased risk of preoperative thromboembolic events in patients with chemoradiotherapy. However, we could not demonstrate any correlation on short and long term mortality.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | 30 |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:04 |
| Last Modified: | 25 Jun 2020 11:04 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2384 |
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