Related Experiment Videos
Multidisciplinary therapy for esophageal cancer
J A Roth1, J A Ajani, T A Rich
1Department of Thoracic Surgery, University of Texas, M.D. Anderson Cancer Center, Houston.
Advances in Surgery
|January 1, 1990
Summary
Combined chemotherapy and radiotherapy show promising survival improvements. Further research is needed to optimize treatment protocols for better patient outcomes and acceptable complication rates.
Area of Science:
- Oncology
- Radiation Oncology
- Medical Oncology
Background:
- Combined-modality therapy (chemotherapy + radiotherapy) shows potential for improved survival rates.
- Pilot trials indicate better 1- and 2-year survival compared to historical controls.
- Mechanisms of interaction between common chemotherapeutic agents and irradiation require further elucidation.
Purpose of the Study:
- To evaluate the efficacy and safety of combined-modality therapy in cancer treatment.
- To explore optimal combinations, doses, and schedules for chemoradiation.
- To assess the impact of preoperative chemoradiation on pathologic complete response rates and survival.
Main Methods:
- Review of pilot trials and ongoing randomized multiinstitutional trials.
- Analysis of reported pathologic complete response rates (37-45%) with preoperative chemoradiation.
- Consideration of specific chemotherapeutic agents like 5-fluorouracil (5-FU), mitomycin C, and cisplatin.
Main Results:
- Pilot studies suggest improved survival statistics with combined therapy.
- Preoperative chemoradiation has shown significant pathologic complete responses in some patient subgroups.
- Ongoing trials aim to confirm these encouraging results against radiotherapy alone.
Conclusions:
- Combined-modality therapy, particularly with 5-FU continuous infusion, warrants consideration.
- Conventionally fractionated radiotherapy in a continuous course is recommended.
- Acute and late complications appear acceptable and comparable to radiotherapy alone.