[Multitherapy of advanced esophageal carcinoma with special reference to pre- and post-operative administration of...

We discussed the results of multitherapy after pre- and post-operative administration of cis-platinum (CDDP) in resected cases of advanced esophageal carcinoma. The patients were, pre-operatively, dosed in the following ways; 1) CDDP (50 mg, 1/week) X 2-3, 2) CDDP (50 mg, 1-week) +BLM (15 mg, 1/week) X 2-3 or +MTX (30mg, 1/week) X 2-3. The patients under went surgery 1 to 2 weeks later. Post-operative administration of CDDP + MTX, or CDDP + BLM was performed 3-4 times about 3 weeks after surgery. Intra-operative and/or post-operative irradiation was also performed. CDDP was administered pre-operatively in 11 cases who ranged in age 45 to 71. Regarding stage, 2 were stIII and 9 were stIV; and curabilities where cIII in 2 cases, c I in 5 and c 0 in 4. With regard to surgery, the right thoracic and abdominal approach was adopted in 7 cases and the left thoracic and abdominal approach adopted in 3. Blunt dissection was performed in 1 case. We have never experienced post-operative complication of histological effects noticed in resected specimens, Ef1 was evaluated in 3/11 and Ef2 was noticed in 2/11. Patients who achieved an Ef2-1 effect due to the administration of CDDP as part of the multitherapy made satisfactory progress. On the other hand, patients who did not react to CDDP and who had marked vascular invasion died after a short period.