Abstract

Prognosis of locoregional esophageal cancer treated with conventional surgery or radiotherapy alone has been very poor. In order to improve outcome and determine the efficacy of a combined modality therapy, this prospective study was performed. Between May 1993 and April l995, 44 patients with locoregional esophageal cancer were entered this study. They were treated with 2 courses of 5-FU(DI-5, D30-33) and cisplatin (Dl, D29) plus 48Gy radiation therapy over 4 weeks. 44 patients completed the preoperative reatment. A transhiatal esophagectomy was planned 3~4 weeks after chemoradiotherapy. Clinical response were reevaluable in 43 patients after treatment: 34 patients showed improvement, 5 patients showed stable, 4 patients showed progression. One patient was died of sepsis 1 week after completion of chemotherapy. l8 patients underwent operation after chemoradiation and 9 patients showed complete pathologic response. Grade 3,4 leukopenia and thrombocytopenia were observed in 21% and 7%, respectively. Esophagitis and vomiting were moderate to severe in 43% patients. Median follow-up duration was 7.5months(2-21M), the median survival was not reached. In conclusion, this intensive combined therapy is promising modality with regards to relatively high pathologic complete response rate. Further randomized Jarge scaled study was warrented

• Keywords: Preoperative chemoradiotherapy, Esophagectomy, Esophageal cancer