Concurrent chemoradiation followed by esophageal resection vs chemoradiation alone for localized esophageal cancer

John D. Hainsworth, MD,¹ Anthony A. Meluch, MD,² James R. Gray, MD,³ David R. Spigel, MD,¹ Christina Meng, BS,¹ James D. Bearden, MD,⁴ Robert Hermann, MD,⁵ and F. Anthony Greco, MD²

¹Sarah Cannon Research Institute, Nashville, TN; ²Sarah Cannon Cancer Center, Nashville, TN; ³Radiation Oncology Associates, Nashville, TN; ⁴Spartanburg Regional Medical Center, Spartanburg, SC; and ⁵Wellstar Cancer Research, Marietta, GA

Patients with localized (clinical stages I–III), potentially resectable carcinoma of the esophagus received concurrent chemotherapy (paclitaxel/carboplatin/infusional 5-fluorouracil [5-FU]) and radiation therapy (45 Gy) for 6 weeks. After restaging, patients who remained surgical candidates were randomly assigned to receive either definitive esophageal resection or continued chemoradiation to a definitive radiation therapy dose (64.8 Gy). In this multicenter community-based study, combined-modality therapy was curative in approximately one third of patients with localized esophageal cancer. Both combined-modality approaches evaluated in the study produced similar results; however, a successful randomized trial is required to define optimal treatment.

Commun Oncol 2007;4:431–439 print e-mail full text 280 kb