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The role of radiation therapy in the preoperative management of esophagogastric adenocarcinoma is the subject of ongoing debate. In esophageal and gastroesophageal junction (GEJ) adenocarcinoma, the NEO-AEGIS trial indicated equipoise for preoperative chemotherapy with ECF (epirubicin, cisplatin, 5-FU) versus preoperative chemoradiotherapy with carboplatin/paclitaxel (NEJM JW Oncol Hematol October 20 2023 and Lancet Gastroenterol Hepatol 2023; 8:1015), and the recent ESOPEC trial indicated superiority of perioperative FLOT (5-FU, leucovorin, oxaliplatin, and docetaxel) over preoperative chemoradiotherapy with carboplatin/paclitaxel.
Investigators now report results of the open-label, randomized, phase 3 TOPGEAR trial in 574 patients with res…