Background. Chemoradiotherapy has demonstrated efficacy in esophageal cancer but rarely is curative. To improve local control and decrease metastases, a 7‐month regimen was used with standard‐dose radiotherapy (RT), cisplatin (DDP), and continuous infusion (CI) 5‐fluorouracil (5‐FU) in patients with locoregional squamous/adenocarcinoma of the esophagus. Methods. Initial treatment consisted of RT to the esophagus (4000‐5000 cGy) for 5‐6 weeks, CI 5‐FU (300 mg/m2/day) concurrent with RT, and DDP (25 mg/m2/ day × 3) for Days 1‐3 and 21‐23. Two monthly cycles of DDP (75 mg/m2 Day 1) and 5‐FU (300 mg/m2 × 21 days) followed. Patients were restaged with endoscopy and computed tomography scan. Patients without evidence of residual disease received three more cycles of chemotherapy (CT); those with persistent tumor underwent esophagectomy or additional CT/RT, and those with disease progression were offered alternative CT. Results. From December 1987 to September 1991, 18 men and 8 women, including 2 with adenocarcinoma, were eligible for inclusion in the study. All were evaluable for toxicity and response. The median age was 61.5 years (range, 50‐80 years), the median pretreatment weight loss was 9 lbs, and the median serum albumin level was 4.3 mg%. Therapy was toxic; 19 patients were hospitalized for treatment‐related esophagitis, thrombosis, or infection. Grade III and IV leucopenia were seen in 12 patients and 1 patient, respectively. One patient had Grade IV thrombocytopenia. Of 26 patients, 17 (65%) had no tumor on restaging. Five patients had recurrences in the esophagus (1), liver (3), and lung (2). Three patients had second neoplasms. The median survival was 24 months. Conclusion. This treatment regimen provides high frequency of local tumor resolution, but with significant toxicity.

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FROM THE DEPARTMENTS OF MEDICINE AND SURGERY, GRASSLANDS HOSPITAL, VALHALLA, N. Y.ARTERIOVENOUS ANEURYSMS are fairly common and rather easily recognized by the classic physical signs which are invariably present, with possible minor variations. We are presenting our experiences with an arteriovenous aneurysm which was unusual in its location. The difficulties encountered in the surgical correction of the condition were considerable. Our findings are analysed and a brief summary of the syndrome is presented.Case Report.-B. J., Negro, male, age 3I, was admitted to Grasslands Hospital, June 26, 1939. Chief Complaint: Unilateral swelling and pain of left side of face of four months duration. Past History: Essentially negative. Malaria as a child. History of luetic infection in I934, with subsequent treatment. Present Illness: Began January 17, I939, when patient was stabbed in the chest. The White Plains Hospital reported a half-inch laceration of the skin, located about one-half inch below the sternal notch over the manubrium sterni, to the left of the midline, which was surrounded by a hematona. The patient expectorated grayish blood-streaked sputum. The laceration was sutured and drained. The patient remained in the White Plains Hospital for four days, during which time roentgenograms of his chest were taken. He left the hospital against advice.In February, 1939, about one month after the accident, the patient began to notice swelling of the left side of his face. Two weeks later he noted a buzzing in his left ear on turning his head to the left. He gradually developed shortness of breath which, on admission, had increased to the point where dyspnea was present on climbing two short flights of stairs. Shortness of breath was also initiated by lying on the left side. During the three months prior to admission, he had a cough productive of three to four ounces of thick sputum per day. The swelling of the left side of the face gradually became more marked and finally involved the left side of the neck. This swelling receded during the daytime, only to return during the night while the patient was lying down. During the weeks previous to his admission the buzzing in his left ear had become more annoying and was present most of the time. For three months previous to admission he had noted soreness under the upper sternum, aching pains down the left arm, and pain in the temporal region.Physical Examination.-Positive Findings: On inspection, there was an obvious unilateral swelling of the left side of the face involving the left cheek, left lower eyelid, the temporal and parietal regions, and extended down over the mandibular region, and entire left side of the neck. The swelling was soft and did not pit. There was no exophthalmos; the pupils were equal and reacted normally; fundi were normal. On auscultation, a double bruit could be heard over the greater part of the swelling, but was loudest over the carotid region of the left side of the neck. The veins over the entire left side of the face, head and neck were swolle...

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