Low dose preoperative radiotherapy for carcinoma of the oesophagus: results of a randomized clinical trial

Locally Advanced Esophageal Cancer

“…One randomized trial revealed no benefit for either preoperative radiation or chemotherapy, concluding that both treatment modalities might be necessary to treat both local and systemic disease. Also, a meta-analysis could not demonstrate a significant survival benefit for preoperative radiation as a single modality (Arnott et al, 1992).…”

“…Whenever a survival benefit was suggested, it tends to be modest, similar to neoadjuvant chemotherapy alone (Arnott et al, 1992;& Nygaard et al, 1992. One randomized trial revealed no benefit for either preoperative radiation or chemotherapy, concluding that both treatment modalities might be necessary to treat both local and systemic disease.…”

Neoadjuvant Treatment for Oesophago-Gastric Cancer

“…The criticisms of the study are that it was retrospective with no statistical analysis of the data. During the 1980's and early 1990's five randomised controlled trials were published comparing neoadjuvant radiotherapy and surgery alone (Launois et al 1981, Gignoux et al 1987, Wang et al 1989, Arnott et al 1992and Nygaard et al 1992. All these studies except for Arnott et al were restricted to treating squamous cell carcinoma.…”

Combined Treatment Modalities in Esophageal Cancer: Should chemotherapy be included?

“…The assumption was that radiation could shrink the tumor and thereby lead to increased resectability. There are 5 prospective randomized trials with 5-year survival data presented (15)(16)(17)(18)(19). The resection rates in these 5 randomized series are high (70-95%) but there is no significant difference between irradiated and non-irradiated patients.…”

“…Operation mortality is not affected by the preoperative radiation and when it comes to long-term survival no benefit has been demonstrated for preoperative RT. In three European materials; Launois et al (15) (17) (20Gy in 10 days) 9% vs 17% 5-year survival for preoperatively irradiated and directly operated patients respectively. The lack of benefit regarding survival for preoperative RT is further substantiated by two Chinese studies (18,19).…”