Chemo/radiation with and without surgery in the thoracic esophagus: The wayne state experience

Herskovic, Arnold; Leichman, Lawrence; Lattin, Paul; Han, Ihn; Ahmad, Khurshid; Leichman, Cynthia G.; Rosenberg, J. C.; Steiger, Zwi; Bendal, Cheryl; White, Barbara; Seydel, H. Gunter; Seyedsadr, Mahmoud; Vaitkevicius, Vainutis K.

doi:10.1016/0360-3016(88)90308-2

Cited by 80 publications

(30 citation statements)

References 6 publications

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“…38 Previous investigations have found that pathologic response is associated with increased survival in patients with esophageal carcinoma who receive multimodality treatment. [2][3][4]6,9,17,21 In the current study, we demonstrated that EUS evaluation of change in tumor size after neoadjuvant therapy correlates with survival. Thus, the results of the current study validate EUS-determined tumor measurement as a useful clinical method that is predictive of survival outcome.…”

Section: Discussionmentioning

confidence: 69%

Endosonographic assessment of multimodality therapy predicts survival of esophageal carcinoma patients

Chak

Canto

Cooper

et al. 2000

Cancer

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Section: Discussionmentioning

confidence: 69%

Endosonographic assessment of multimodality therapy predicts survival of esophageal carcinoma patients

Chak

Canto

Cooper

et al. 2000

Cancer

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“…Esophageal cancer has a poor prognosis due to high rates of local recurrence and distant metastasis (1,2). About one half of patients presented with locally advanced stage at the time of diagnosis (3) and have a 5-year survival rate of ,30% after surgical resection or multimodality therapy.…”

Section: Introductionmentioning

confidence: 99%

High-dose Versus Standard-dose Radiotherapy with Concurrent Chemotherapy in Stages II–III Esophageal Cancer

Suh

Lee

Koom

et al. 2014

Japanese Journal of Clinical Oncology

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Objective: In this study, we investigated the effects of radiotherapy 60 Gy in the setting of concurrent chemo-radiotherapy for treating patients with Stages II -III esophageal cancer. Methods: A total of 126 patients treated with 5-fluorouracilbased concurrent chemo-radiotherapy between January 1998 and February 2008 were retrospectively reviewed. Among these patients, 49 received a total radiation dose of ,60 Gy (standard-dose group), while 77 received a total radiation dose of 60 Gy (high-dose group). The median doses in the standard-and high-dose groups were 54 Gy (range, 45-59.4 Gy) and 63 Gy (range, 60 -81 Gy), respectively. Results: The high-dose group showed significantly improved locoregional control (2-year locoregional control rate, 69 versus 32%, P , 0.01) and progression-free survival (2-year progression-free survival, 47 versus 20%, P ¼ 0.01) than the standard-dose group. Median overall survival in the high-and the standard-dose groups was 28 and 18 months, respectively (P ¼ 0.26). In multivariate analysis, 60 Gy or higher radiotherapy was a significant prognostic factor for improved locoregional control, progression-free survival and overall survival. No significant differences were found in frequencies of late radiation pneumonitis, post-treatment esophageal stricture or treatment-related mortality between the two groups. Conclusions: High-dose radiotherapy of 60 Gy or higher with concurrent chemotherapy improved locoregional control and progression-free survival without a significant increase of in treatment-related toxicity in patients with Stages II -III esophageal cancer. Our study could provide the basis for future randomized clinical trials.

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“…In the trial of Herskovic et al [7] resection rate was lower, because only patients with clinically recurrent tumors were planned to undergo surgery. In an earlier trial [18] Herskovic et al compared patients with combined radiotherapy and chemotherapy with or without following surgery and found a worse median survival time in the group of patients who underwent surgery (median survival of 10 vs. 22 months). At present neither does it seem clear whether surgical resec tion should be performed under all circumstances and in all patients, nor have the optimal timing of surgical resection and its extent been assessed properly.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous 5-Fluorouracil, Cisplatinum and Radiation Therapy for Patients with Locally Advanced Squamous Cell Carcinoma of the Esophagus

Hieber

Heim

Trux³

et al. 1994

Oncol Res Treat

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Background: Diagnostic tools and operative methods of esophageal cancer were improved during the last years, but the 5-year survival of patients with nonresect-able squamous cell carcinoma of the esophagus is still below 5%. With a combined modality therapy (chemotherapy and simultaneous radiation therapy) tumor regression can be achieved for secondary resection. The intention of this investigation was to reduce tumor mass and obtain secondary operability. Patients and Methods: In our investigation 24 patients with a primarily inoperable squamous cell carcinoma of the esophagus received on days 1-5 and days 29-33 a chemotherapy with 5-fluorouracil as a continuous infusion of 1,000 mg/m2 daily over 24 h and cisplatinum 20 mg/m2 as short infusion daily over 60 min, combined with a simultaneous radiotherapy using a total dose of 30 Gy. Results: Of the 20 evaluable patients 2 had a complete and 12 a partial remission, suggesting an overall response rate of 70%. The median duration of response in the group without esophageal resection was 8.3 months. The survival after 1 year was 54%. 9/24 patients underwent secondary surgery. Esophagus resection was performed in 5 patients; in 3 patients the carcinoma was not resectable, in 1 patient resection was not done because of a formerly undetected lung metastasis. Conclusions: In patients with primarily nonresectable esophageal carcinoma after combined radio-/chemotherapy and tumor regression an attempt should be made to resect carcinoma in a secondary surgical intervention.

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Chemo/radiation with and without surgery in the thoracic esophagus: The wayne state experience

Cited by 80 publications

References 6 publications

Endosonographic assessment of multimodality therapy predicts survival of esophageal carcinoma patients

Endosonographic assessment of multimodality therapy predicts survival of esophageal carcinoma patients

High-dose Versus Standard-dose Radiotherapy with Concurrent Chemotherapy in Stages II–III Esophageal Cancer

Simultaneous 5-Fluorouracil, Cisplatinum and Radiation Therapy for Patients with Locally Advanced Squamous Cell Carcinoma of the Esophagus

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