The Annals of Thoracic Surgery, Vol 40, 121-125, Copyright © 1985 by The Society of Thoracic Surgeons
Chemoradiation therapy and resection for carcinoma of the esophagus: short-term results
EF Parker, RD Marks Jr, JM Kratz, A Chaikhouni, ET Warren and DM Bartles
The purpose of this report is to record the results of a treatment protocol
for patients with carcinoma of the esophagus. In May, 1980, we initiated a
program of chemoradiation therapy preliminary to resection in patients in
whom the protocol was applicable. The chemotherapy consisted of
mitomycin-C, 10 mg as a bolus intravenous injection on day 1, and
5-fluorouracil, 1,000 mg per square meter of body surface area in 1,000 ml
of 5% glucose solution in distilled water given intravenously on each of
days 1 through 4. The radiation therapy consisted of 3,000 rads in three
weeks using cobalt 60 or 6 MeV or greater, with ports to cover the tumor
and mediastinum. This protocol was given to patients with primary carcinoma
of the esophagus whose disease remained or became operable during or
following the course of the chemoradiation. Among the patients treated
according to the protocol, the operability rate was increased. The
resectability rate remained about the same as in our previous experience.
The operative mortality was lessened appreciably. The percentage of
resected specimens of the esophagus showing residual tumor decreased.
However, the absence of any residual tumor in the surgical specimen has not
conferred any improved chance of long-term survival to date. There has been
a two-year survival of 33% (7/21) among the small group having
chemoradiation therapy prior to resection, and this figure is roughly the
same as that in our previously reported series of patients treated by
preoperative irradiation (4,500 rads in three weeks) and resection without
the chemotherapeutic adjunct.(ABSTRACT TRUNCATED AT 250 WORDS)
