Preoperative radiation and chemotherapy for localized squamous cell carcinoma of the esophagus: a RTOG study

Chemoradiotheraphy of Esophageal Cancer

“…In our own study published in 1991, 20% received a histologically complete response, and in this group all patients were long-term survivors. In all studies so far reported, improved survival is observed for patients who are pathologically complete responders (40)(41)(42)(43)(44)(45)(46)(47). A recently reported abstract of a Medical Research Council trial of chemotherapy before surgery versus surgery alone shows a statistically signi cant improvement in survival (48).…”

“…The swallowing function is often well restituted for responding patients and for those with remaining tumors surgical salvage is still possible. Several studies with preoperative chemoradiation have shown that a pathologically complete remission is predictive of those who will be long-term survivors (40)(41)(42)(43)(44)(45)(46)(47). This also stresses the need for a surgical resection.…”

Combined chemotherapy and radiotherapy followed by surgery in the treatment of patients with squamous cell carcinoma of the esophagus

“…33 However, randomized studies have not shown an advantage for preoperative chemotherapy over surgery alone in overall survival, DFS, or local control rates 34 -36 (2-year survival, 35% vs. 37% for surgery alone). By combining chemotherapy and radiotherapy prior to surgery, the outcome for patients with Stage I-III tumors seems to be improved, with a mean survival rate of 26.5% at 2 years 6,8,34,[37][38][39][40] and a low (Ͻ 5%) hospital mortality rate. 24,[41][42][43] Walsh et al 44 showed clearly that multimodal therapy is superior to surgery alone for patients with esophageal adenocarcinoma, with a 3-year survival rate of 32% versus 6%.…”

Role of radiotherapy in the pre-operative management of carcinoma of the esophagus

“…Median survival was 12 mo and 3 year survival 16% [7] . The RTOG study had even poorer survival [6] . Several other phase Ⅱ trials incorporating tri-modality therapy have been done, including some incorporating newer chemotherapy agents including paclitaxel, carboplatin and oxaliplatin.…”

“…The use of pre-operative chemoradiotherapy in esophageal cancer was first used in 2 phase Ⅱ studies based in the United States [6,7] . The Southwestern Oncology Group trial accrued 113 patients treated with pre-operative chemoradiotherapy using concurrent cisplatin, fluorouracil and 30 Gy.…”