PURPOSE: We clinically evaluated 12 patients with advanced superficial esophageal cancer who had undergone chemoradiotherapy. PATIENTS AND METHODS: A retrospective analysis was performed between October 1992 and December 1998 on 12 patients with M1 metastasis in lymph nodes or direct invasion of enlarged lymph nodes (A3) to adjacent structures. Combined treatment with radiotherapy and chemotherapy was applied to all patients. High-dose cisplatin (CDDP) and 5-fluorouracil (5-FU) were administered to five patients, low-dose CDDP and 5-FU to five patients, and others to two patients. Ten patients were treated by external irradiation alone, and two patients were treated by external and intracavitary irradiation. RESULTS: Of the 12 patients, the response of the primary tumor to this therapy resulted in 11 CRs (91.6%) and one PR, while the response of the largest metastatic lesion in lymph nodes in each patient resulted in three CRs (25%), four PRs (33.3%), and five NCs (41.6%). The 2-year survival rate of all patients was 51.9%, and MST was 28.9 months. The 2-year survival rates of the M1 and A3 patients were 60.0% and 41.7%, respectively. CONCLUSION: This study revealed that the present chemotherapy regimen is ineffective in treating metastatic lymph node lesions. Therefore, it will be necessary to evaluate the effectiveness of chemoradiotherapeutic agents from the perspective of their effects on metastatic lymph nodes.

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PubMedDate not supplied

Outcomes of radiotherapy for inoperable locally advanced (T4) esophageal cancer-retrospective analysis-.

To assess the treatment outcome after radiotherapy with or without chemotherapy for inoperable locally advanced (T4) esophageal cancer (EC), a retrospective analysis was performed. We enrolled 37 patients with T4 EC and analyzed 35 patients. A total of 28 patients were treated with radiotherapy and chemotherapy (median dose, 60 Gy) and seven patients were treated with radiation alone (median dose, 60 Gy). Many mainly received high-dose cisplatin (CDDP) and 5-fluorouracil (FU) or continuous infusion of low-dose CDDP and 5-FU. Among the 35 patients, there were eight survivors and 27 deaths. The median follow-up period was 15.5 months (3.5 to 74 months). The one-year, 3-year, and 5-year survival rates were 37.5%, 10.0%, and 10.0%, respectively, with a median survival time (MST) of 7.3 months. When the patients were divided into two groups, a complete response (CR) group and a non-CR group, MST was 16.5 and 6.2 months, respectively, showing significant differences between the two groups (p=0.0317). CR patients showed more satisfactory long-term outcomes than non-CR patients.

Antineoplastic Agents↗