[Neoadjuvant chemoradiotherapy in esophageal cancer]

From June 1987 to December 1993 in our Institute we treated with neoadjuvant chemo-radiotherapy 94 patients with esophageal squamous carcinoma. The neoadjuvant protocol consisted in 3000 cGy and two cycles of chemotherapy (5-FU, 1000 mg/m2, 100 mg/m2 DDP). At the end of this treatment patients underwent surgery. Operability rate was 76.6%, post-operative morbidity was not affected by the neoadjuvant treatment and post-operative mortality rate was 9.5%. Histopathology showed in 15 cases no residual disease (T0) and in 12 patients minimal residual of disease, with isolated neoplastic microfoci in the esophageal wall. The longest survival was of seventy months with medium follow-up of 16.8 months. Overall actuarial survival (Kaplan-Meier test) at one, two, three years were 54%, 34%, and 23% respectively. Our experience showed a better survival of the patients treated with surgery alone, a better operability and resectability rates. However, it is mandatory to wait for the results of perspective randomized studies to evaluate the real advantages of this treatment.