Treatment of Esophageal Carcinoma by Pre-operative Chemo-radiotherapy Modality "Cancer Research Center, Mashhad University of Medical Sciences"

Document Type : Research Paper

Authors

1 Assistant Professor of Radiotherapy and Oncology, Omid Hospital, Mashhad University of Medical Sciences

2 Rad. Oncologist, Omid Hospital, Mashhad University of Medical Sciences

3 Resident of Rad. Oncology, Mashhad University of MedicalSciences

4 General Practitioner, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Introduction
 
Combined modality treatments have been proposed for improving survival in patients with esophageal carcinoma. In this study, we evaluated the results of neoadjuvant radiotherapy and chemotherapy followed by surgery in patients with esophageal Squamous Cell Carcinoma (SCC).
 
Materials and Methods
 
Between September 2001 and September 2006, 75 patients with Operable esophageal SCC underwent neoadjuvant radiotherapy (30 Gray/10 fractions in 34 or 40 Gray/20 fractions in 41 cases) followed by trans-hiatal esophagectomy at Omid Hospital, Mashhad, Iran. A total of 42 patients received at least 3 courses of chemotherapy containing cisplatin and 5FU.
 
Results
 
Complete response to neoadjuvant treatment was found in 5 cases (6.7%). With a median follow up time of 13 months, 21 cases (28%) experienced recurrence including 9 locoregional recurrences, 9 distant metastasis and 3 concomitant local and distant failure. Period of 3-year survivals for all patients was 62.2%. There was no significant difference in survival between patients treated with either radiotherapy protocols (p=0.37). Patients who received at least 3 courses of chemotherapy had relatively better survival compared with those receiving less than three courses or no chemotherapy (p=0.09). In comparison with patients having grade III tumors, patients with grade I & II tumors had significantly better survival rate (p=0.05).
 
Major treatment complications included leukopenia in 13 (17%), anemia in 6 (8%), Thrombocytopenia in 2 (3%), postsurgical fistula in 2 (3%) and anastomosis stricture in 8 (11%) patients.
 
Conclusion
 
In this study, neoadjuvant chemoradiotherapy and surgery achieved satisfactory survival and acceptable incidence of complications for patients with esophageal SCC and we recommend further investigation in this regard.

Keywords

References

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medical journal of mashhad university of medical sciences
Volume 52, Issue 3 - Serial Number 3
September and October 2008
Pages 173-179

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