TUMOR RESPONSE TO NEOADJUVANT CHEMOTHERAPY IN CARDIOESOPHAGEAL JUNCTION CANCER

Abstract

Neoadjuvant chemotherapy (NACT) plays an important role in the multimodal treatment of cardioesophageal junction cancer (CEJC), particularly in locally advanced stages. This study evaluated the clinical and pathological effectiveness of neoadjuvant chemotherapy administered according to FLOT and DCF regimens in patients with stage IIIb–IVa disease. Forty-seven patients received 4–6 cycles of chemotherapy, and treatment response was assessed using MSCT or PET-CT imaging and repeat histological examination. Overall treatment response was achieved in 87.2% of patients, including complete regression in 19.1% and partial regression in 68.0% of cases. Pathological response assessment according to Lavnikova’s criteria demonstrated grade III–IV therapeutic pathomorphosis in 12.8% of patients. Although adverse effects were observed in 59.4% of cases, severe toxicity (grade III) was rare and manageable. The findings confirm the clinical effectiveness of neoadjuvant chemotherapy in locally advanced cardioesophageal junction cancer, while indicating its partial but not definitive impact on tumor regression.