# CROSS

Source: https://onco.cc/trials/cross-trial/  
OnCo record `cross-trial` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

CROSS made chemoradiation before surgery the standard for oesophageal cancer: five weeks of weekly chemotherapy with radiotherapy nearly doubled median survival compared with surgery alone.

## Summary

CROSS randomised 368 patients with resectable oesophageal or gastro-oesophageal junction cancer to surgery alone or five weekly cycles of carboplatin-paclitaxel with 41.4 Gy in 23 fractions followed by surgery. Median overall survival was 49.4 months with chemoradiation versus 24.0 months with surgery alone (hazard ratio 0.66), 29 percent had a pathological complete response, and surgical complications were not increased (van Hagen and colleagues, New England Journal of Medicine 2012). Ten-year follow-up confirmed the benefit; the CROSS regimen is a worldwide standard.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-17
- Tags: radiation-wave4
- Phase: 3
- Setting: Resectable oesophageal or junctional cancer: neoadjuvant carboplatin-paclitaxel with 41.4 Gy radiotherapy then surgery, versus surgery alone
- Sponsor: Dutch CROSS study group
- Enrolled: 368
- Result: Median overall survival 49.4 vs 24.0 months (hazard ratio 0.66); pathological complete response 29%.
- Outcomes: Median overall survival: Chemoradiation then surgery 49.4 months vs Surgery alone 24 months

## Sources

- NEJM 2012: https://doi.org/10.1056/NEJMoa1112088

## Connected records

- cancers: [Gastric & gastro-oesophageal junction cancer](https://onco.cc/cancers/gastric/), [Oesophageal and junctional adenocarcinoma](https://onco.cc/cancers/oesophageal-adenocarcinoma/), [Oesophageal cancer](https://onco.cc/cancers/esophageal/), [Oesophageal squamous cell carcinoma](https://onco.cc/cancers/oesophageal-squamous-cell-carcinoma/)
- technologies: [IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/), [Radiosensitisers](https://onco.cc/technologies/radiosensitisers/)
- drugs: [Carboplatin](https://onco.cc/drugs/carboplatin/), [Paclitaxel / nab-paclitaxel](https://onco.cc/drugs/paclitaxel/)
- terms: [Chemoradiation (chemoradiotherapy, CRT)](https://onco.cc/terms/chemoradiation/)

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