A prospective study of combined chemoradiotherapy followed by surgery in the treatment of esophageal carcinoma.
- Author:
Feng-shan AN
1
;
Jin-qiu HUANG
;
Ying-tao XIE
;
Shao-hu CHEN
;
Tie-hua RONG
Author Information
- Publication Type:Clinical Trial
- MeSH: Adenocarcinoma; drug therapy; radiotherapy; surgery; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; administration & dosage; therapeutic use; Carcinoma, Squamous Cell; drug therapy; radiotherapy; surgery; Chemotherapy, Adjuvant; Cisplatin; administration & dosage; Esophageal Neoplasms; drug therapy; radiotherapy; surgery; Esophagectomy; Female; Fluorouracil; administration & dosage; Humans; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Particle Accelerators; Prospective Studies; Radiotherapy, Adjuvant; Survival Rate
- From: Chinese Journal of Oncology 2003;25(4):376-379
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo evaluate the effect of combined chemoradiotherapy followed by surgery for patients with esophageal carcinoma.
METHODSNinety-seven patients with stage II or III esophageal carcinoma without contraindication against operation and chemoradiotherapy, were randomly divided into two groups: combined group (Group A) 48 and control group (Group B) 49. Patients in group A were given neoadjuvant treatment consisted of chemotherapy with 5-fluorouracil and cisplatin for 2 cycles and radiotherapy of DT36 Gy/12 f/17 d. Three weeks later, operation was performed. Patients in group B were given operation alone. Survival rate was calculated with Kaplan-Meier method. Chi and Log-rank test was used to assess the difference between the two groups.
RESULTSThe radical resectability of group A and group B were 85.4% and 65.3% (P = 0.018 1). The lymph node metastasis rate of the two groups were 21.7% and 45.7% (P = 0.019 4). The T stage of group A was significantly lowered (P = 0.003 6). The local and regional recurrence rate of two groups were 34.8% and 58.7% (P = 0.023 6), while there was no significant difference in operative complications between the two groups. Significant improvement in the long-term survival rate was observed in group A, especially in patients who achieved partial and complete response with high 5-year survival rate of 56.5%.
CONCLUSIONPreoperative neoadjuvant chemoradiotherapy is able to reduce the tumor and tumor stage, lower the lymph node metastasis rate and local or regional recurrence rate, also it can improve radical resectability and long-term survival without increasing the operative complications.
