CROSS
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.
Overview
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.
- Median 49.4 vs 24 months with Chemoradiation then surgery compared with Surgery alone; about 25.4 months longer for half the group.
- A median is a midpoint: half the people did better than this and half did worse, so it is not a prediction for any one person.
- Overall survival counts deaths from any cause, so it is the most direct measure of whether a treatment helps people live longer.
- These results apply to the people the trial enrolled: Resectable oesophageal or junctional cancer: neoadjuvant carboplatin-paclitaxel with 41.4 Gy radiotherapy then surgery, versus surgery alone. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
368 participants enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Median overall survivalprimary | Chemoradiation then surgery | 178 | 49.4 months | - | - | - |
| Surgery alone | 188 | 24 months |
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