Experience with cisplatin in treatment regimens for esophageal cancer

This article reviews the rationale for chemotherapy (especially cisplatin-based treatments) in the management of epidermoid tumors of the esophagus. It focuses on the history of cisplatin and cisplatin-based combinations in the treatment of metastatic and localized esophageal cancers. The seminal chemotherapy trials of investigators at Memorial Sloan Kettering Cancer Center are reviewed and placed into perspective as a body of work that systematically measured the effects of chemotherapy in the treatment of primary tumors within the esophagus. The Wayne State University (Detroit, MI) program and subsequent similar programs, combining chemotherapy with concomitant radiation, are also reviewed and placed into historical context. Recently completed prospectively randomized cooperative group trials have now shown that chemotherapy in addition to radiation improves survival of patients with localized esophageal cancers versus radiation alone. While no standard chemotherapeutic regimen has come to the fore, chemotherapy clearly has a role in the curative treatment of epidermoid tumors of the esophagus.