Combined modality therapy for oesophageal squamous cell carcinoma

In a prospective study 110 patients with histologically confirmed oesophageal squamous cell carcinoma received radiation therapy combined with bleomycin or a retinoid. Surgery was initially intended in 34 patients and was later on undertaken in 25 of them after irradiation; in 12 patients the operation was regarded as radical and in 4 of these no remaining tumour was found at operation. The survival rate was significantly higher in the operated than in the non-operated patients which entirely depended on the radically operated ones. Survivals up to more than 71 months were observed and the best results were apparently obtained in patients who became tumour-free after preoperative therapy. It is concluded, that the combined treatment was curative only in a few cases and that future studies should be focused on more intensive preoperative treatment and more critical selection of patients for surgery.