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1. Hirsh V, Soulieres D, Duclos M, Faria S, Del Vecchio P, Ofiara L, Ayoub JP, Charpentier D, Gruber J, Portelance L, Souhami L: Phase II multicenter trial with carboplatin and gemcitabine induction chemotherapy followed by radiotherapy concomitantly with low-dose paclitaxel and gemcitabine for stage IIIA and IIIB non-small cell lung cancer. J Thorac Oncol; 2007 Oct;2(10):927-32
Hazardous Substances Data Bank. CARBOPLATIN .

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  • [Title] Phase II multicenter trial with carboplatin and gemcitabine induction chemotherapy followed by radiotherapy concomitantly with low-dose paclitaxel and gemcitabine for stage IIIA and IIIB non-small cell lung cancer.
  • INTRODUCTION: The optimal combination of concomitant radiotherapy (RT) and chemotherapy in stage III unresectable non-small cell lung cancer (NSCLC) remains unclear.
  • The role of induction chemotherapy with carboplatin/gemcitabine regimen has not been established in stage III NSCLC.
  • METHODS: Forty-two stage III NSCLC patients, 41 assessable, with a median age of 60 years and good performance status, entered this trial between January 2003 and November 2004.
  • They received carboplatin area under the curve 5 on day 1 and gemcitabine 1000 mg/m2 on days 1 + 8 every 3 weeks for two cycles, followed on day 50 by RT 60 Gy, concomitantly with paclitaxel 50 mg/m2 and gemcitabine 100 mg/m2 on days 1 + 8 every 3 weeks for two cycles.
  • During concomitant RT and chemotherapy, grade 3 neutropenia, thrombocytopenia, and anemia occurred in eight, three, and three patients, respectively, and grade 4 neutropenia and thrombocytopenia in one patient each.
  • One patient developed an esophageal fistula and died shortly after, which was considered a grade 5 toxicity; one patient developed grade 4 interstitial pneumonitis, and three patients developed grade 3 esophagitis.
  • Further studies using this approach are warranted in patients with stage III NSCLC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Non-Small-Cell Lung / therapy. Lung Neoplasms / therapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / pathology. Adenocarcinoma / radiotherapy. Adult. Aged. Carboplatin / administration & dosage. Carcinoma, Large Cell / drug therapy. Carcinoma, Large Cell / pathology. Carcinoma, Large Cell / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / radiotherapy. Combined Modality Therapy. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Dose-Response Relationship, Drug. Female. Humans. Male. Maximum Tolerated Dose. Middle Aged. Neoplasm Staging. Paclitaxel / administration & dosage. Prognosis. Prospective Studies. Radiotherapy Dosage. Remission Induction. Survival Rate. Treatment Outcome

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  • (PMID = 17909355.001).
  • [ISSN] 1556-1380
  • [Journal-full-title] Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
  • [ISO-abbreviation] J Thorac Oncol
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine; BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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2. Keresztes RS, Port JL, Pasmantier MW, Korst RJ, Altorki NK: Preoperative chemotherapy for esophageal cancer with paclitaxel and carboplatin: results of a phase II trial. J Thorac Cardiovasc Surg; 2003 Nov;126(5):1603-8
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  • [Title] Preoperative chemotherapy for esophageal cancer with paclitaxel and carboplatin: results of a phase II trial.
  • OBJECTIVE: Paclitaxel has one of the highest response rates when used as a single agent in patients with esophageal cancer.
  • The combination of paclitaxel and carboplatin has been shown to be a well-tolerated and safe regimen in non-small cell lung cancer.
  • The objective of this study was to determine the efficacy of preoperative paclitaxel and carboplatin in patients with carcinoma of the esophagus.
  • PATIENTS AND METHODS: A phase II trial was initiated in January 1999 and concluded in January 2001.
  • Patients with stage I disease and those with visceral metastases were excluded.
  • All underwent preoperative computed tomography scanning and endosonography for staging.
  • Preoperative staging showed: stage IIA, 6 patients; stage IIB, 1 patient; and stage III, 19 patients.
  • All patients completed their preoperative chemotherapy.
  • There was no unexpected chemotherapy-related toxicity.
  • CONCLUSION: Paclitaxel-carboplatin combination is a safe and well-tolerated regimen for esophageal cancer with clinical response rates comparable to historical controls.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Carboplatin / administration & dosage. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / mortality. Paclitaxel / administration & dosage
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / mortality. Adenocarcinoma / pathology. Adenocarcinoma / surgery. Adult. Aged. Analysis of Variance. Biopsy, Needle. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / mortality. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / surgery. Chemotherapy, Adjuvant. Confidence Intervals. Dose-Response Relationship, Drug. Esophagectomy / methods. Female. Follow-Up Studies. Humans. Male. Maximum Tolerated Dose. Middle Aged. Neoplasm Staging. Pilot Projects. Preoperative Care / methods. Risk Assessment. Survival Analysis. Treatment Outcome

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  • (PMID = 14666040.001).
  • [ISSN] 0022-5223
  • [Journal-full-title] The Journal of thoracic and cardiovascular surgery
  • [ISO-abbreviation] J. Thorac. Cardiovasc. Surg.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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3. Kodaira T, Fuwa N, Kamata M, Furutani K, Tachibana H, Yamazaki T: Single-institute phase I/II trial of alternating chemoradiotherapy with 5-FU and nedaplatin for esophageal carcinoma. Anticancer Res; 2006 Jan-Feb;26(1B):471-8
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  • [Title] Single-institute phase I/II trial of alternating chemoradiotherapy with 5-FU and nedaplatin for esophageal carcinoma.
  • AIM: To assess the efficacy and feasibility of alternating chemoradiotherapy for esophageal cancer.
  • MATERIALS AND METHODS: Patients, with previously untreated esophageal cancer, Eastern Cooperative Oncology Group performance status of 0 to 2, age 20 to 75 years and sufficient organ function, were eligible for this study.
  • Three cycles of systemic chemotherapy with the continuous infusion of 3500 mg/m2 of 5-fluorouracil (5-FU: days 1-5) and a 6-h infusion of nedaplatin (NDP; day 6: 120-140 mg/m2), were accompanied by thoracic irradiation of 63 Gy in 35 fractions over 7 weeks.
  • Radiation therapy was stopped during systemic chemotherapy (alternating setting).
  • For the phase II part, patients with distant metastasis were excluded.
  • The median patient age was 54 years (range, 49-65 years) for the phase I and 58 years (range, 44-73 years) for the phase II trials.
  • Twenty-five patients were treated with the recommended doses in the phase II part of the study.
  • Ten patients had T4 disease and 14 patients had stage IV disease in the phase II part of the study.
  • Radiation esophagitis of grade 3 or greater developed in 6 patients (24%).
  • CONCLUSION: This intensive treatment for esophageal cancer was feasible and effective; however, moderate-to-severe toxicity occurred.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Dose-Response Relationship, Drug. Dose-Response Relationship, Radiation. Drug Administration Schedule. Feasibility Studies. Female. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Humans. Male. Middle Aged. Organoplatinum Compounds / administration & dosage. Organoplatinum Compounds / adverse effects

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  • (PMID = 16739307.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Organoplatinum Compounds; 8UQ3W6JXAN / nedaplatin; U3P01618RT / Fluorouracil
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4. Bains MS, Stojadinovic A, Minsky B, Rusch V, Turnbull A, Korst R, Ginsberg R, Kelsen DP, Ilson DH: A phase II trial of preoperative combined-modality therapy for localized esophageal carcinoma: initial results. J Thorac Cardiovasc Surg; 2002 Aug;124(2):270-7
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  • [Title] A phase II trial of preoperative combined-modality therapy for localized esophageal carcinoma: initial results.
  • OBJECTIVE: We sought to evaluate treatment response to a novel combined-modality treatment regimen for localized esophageal carcinoma.
  • METHODS: Localized esophageal carcinoma was confirmed with endoscopic ultrasonography, computed tomography, and positron emission tomography before induction therapy.
  • This therapy consisted of combined cisplatin/paclitaxel (cisplatin, 75 mg/m(2); paclitaxel, 175 mg/m(2); 2 cycles, 3-hour infusion) for weeks 1 and 4, combined cisplatin (30 mg. m(-2).
  • wk(-1), 96-hour infusion) with concurrent radiation (external beam, 1.8 Gy/d; total, 50.4 Gy) for weeks 7 to 12, and esophagectomy for week 16 after restaging confirmed resectability.
  • RESULTS: Forty-one patients (36 men) with adenocarcinoma (n = 25) or squamous cell carcinoma (n = 16) were enrolled.
  • Thirty-six patients completed treatment, of whom 34 (85%) had locally advanced disease of clinical stage T3-4 N0-1.
  • Symptoms resolved or improved in 35 (92%) of 38 patients after induction chemotherapy.
  • Fourteen (35%) and 10 (24%) patients experienced grade III/IV myelosuppression during induction chemotherapy and chemoradiation, respectively.
  • Only 2 (5%) patients required enteral feeding-tube support during therapy.
  • CONCLUSION: This regimen of induction concurrent chemoradiation followed by surgical intervention for esophageal carcinoma produces rapid dysphagia relief with initial chemotherapy, has a high overall response rate, and has acceptable toxicity levels.
  • [MeSH-major] Adenocarcinoma / therapy. Carcinoma, Squamous Cell / therapy. Esophageal Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols. Cisplatin / administration & dosage. Combined Modality Therapy. Diagnostic Imaging. Female. Humans. Male. Middle Aged. Paclitaxel / administration & dosage. Treatment Outcome

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  • (PMID = 12167786.001).
  • [ISSN] 0022-5223
  • [Journal-full-title] The Journal of thoracic and cardiovascular surgery
  • [ISO-abbreviation] J. Thorac. Cardiovasc. Surg.
  • [Language] eng
  • [Grant] United States / NCPDCID CDC HHS / CI / NCI U01 166913
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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5. Lustberg MB, Bekaii-Saab T, Young D, Otterson G, Burak W, Abbas A, McCracken-Bussa B, Lustberg ME, Villalona-Calero MA: Phase II randomized study of two regimens of sequentially administered mitomycin C and irinotecan in patients with unresectable esophageal and gastroesophageal adenocarcinoma. J Thorac Oncol; 2010 May;5(5):713-8
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  • [Title] Phase II randomized study of two regimens of sequentially administered mitomycin C and irinotecan in patients with unresectable esophageal and gastroesophageal adenocarcinoma.
  • BACKGROUND: Based on the observation of topoisomerase-1, upregulation by mitomycin C (MMC), and the phase I antitumor activity of sequential MMC/irinotecan in esophageal cancer, we conducted a phase II evaluation of two schedules of this combination in previously untreated stage III/IV esophageal/gastroesophageal junction adenocarcinomas.
  • A two-stage Simon minimax design was used for each arm, with a "pick-the-winner" approach based on efficacy.
  • CONCLUSION: Irinotecan/MMC is feasible in esophageal/gastroesophageal junction adenocarcinoma.

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  • (PMID = 20354452.001).
  • [ISSN] 1556-1380
  • [Journal-full-title] Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
  • [ISO-abbreviation] J Thorac Oncol
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / P30 CA16059; United States / NCI NIH HHS / CA / R21 CA092956; United States / NCRR NIH HHS / RR / UL1 RR025755; United States / NCI NIH HHS / CA / K12 CA133250; United States / NCI NIH HHS / CA / P30 CA016059; United States / NCI NIH HHS / CA / R21CA92956
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; 7673326042 / irinotecan; XT3Z54Z28A / Camptothecin
  • [Other-IDs] NLM/ NIHMS460376; NLM/ PMC3641556
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6. Knox JJ, Wong R, Visbal AL, Horgan AM, Guindi M, Hornby J, Xu W, Ringash J, Keshavjee S, Chen E, Haider M, Darling G: Phase 2 trial of preoperative irinotecan plus cisplatin and conformal radiotherapy, followed by surgery for esophageal cancer. Cancer; 2010 Sep 1;116(17):4023-32
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  • [Title] Phase 2 trial of preoperative irinotecan plus cisplatin and conformal radiotherapy, followed by surgery for esophageal cancer.
  • BACKGROUND: Esophagectomy for locally advanced esophageal cancer (LAEC) is associated with limited survival.
  • Trimodality therapy yields a small survival advantage, with cisplatin and 5-fluorouracil regimens most frequently studied.
  • METHODS: Patients with LAEC of the thoracic esophagus or gastroesophageal junction underwent chemotherapy with preoperative irinotecan (65 mg/m(2)) plus cisplatin (30 mg/m(2)) on Weeks 1, 2, 4, 5, 7, and 8 with concurrent conformal radiotherapy (40 grays [Gy]/20 fractions during Weeks 4-7) and external beam boost (10 Gy/5 fractions at Week 8).
  • Nineteen patients had American Joint Committee on Cancer stage II, 22 had stage III, and 11 had stage IVA disease.
  • Three patients withdrew from treatment due to toxicity.
  • There was 1 treatment-related death.
  • Median and 3-year overall survival for patients receiving trimodality therapy was 36 months and 51%, respectively.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Camptothecin / analogs & derivatives. Cisplatin / administration & dosage. Esophageal Neoplasms / therapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / surgery. Adult. Aged. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Carcinoma, Squamous Cell / surgery. Combined Modality Therapy. Esophagectomy. Esophagogastric Junction. Female. Humans. Male. Middle Aged. Neoadjuvant Therapy. Radiotherapy, Conformal

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  • [Copyright] Cancer 2010. (c) 2010 American Cancer Society.
  • (PMID = 20533506.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 7673326042 / irinotecan; Q20Q21Q62J / Cisplatin; XT3Z54Z28A / Camptothecin
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7. Farzad M, De Luca MC, Rubino G, Pirtoli L, Pepi F, Sebaste L, Ponticelli P, Atzeni G, Maranzano E, Silvano G: [Effort to radically cure stage III and IV esophageal carcinoma with simultaneous radiotherapy and chemotherapy in standard clinical practice]. Radiol Med; 2001 Jul-Aug;102(1-2):72-7
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  • [Title] [Effort to radically cure stage III and IV esophageal carcinoma with simultaneous radiotherapy and chemotherapy in standard clinical practice].
  • [Transliterated title] L'intento di cura radicale del carcinoma esofageo al III e IV stadio con radioterapia e chemioterapia concomitanti nella pratica clinica comune.
  • PURPOSE: Chemotherapy and concurrent irradiation, intended to cure, are presently standard treatments for non metastatic, unresectable oesophageal cancer.
  • The results of the combined therapy are superior to those of radiotherapy alone, attaining 25-35% 2-year survival rates.
  • However these results mainly refer to stage I and II tumours as most of the available literature has focussed on these groups.
  • The aim of our report is to present our experience with Stage III and IV patients.
  • MATERIAL AND METHODS: Sixty-four Stage III and IV oesophageal cancer patients were referred to our Departments from January 1, 1990 to December 31, 1996.
  • Diagnosis was obtained through oesophagoscopy and biopsy, stage was assessed by physical examination, chest CT scan, bronchoscopy, barium X-ray examination, upper abdomen ultrasonography and bone nuclide scan.
  • The case features were as follows: histology of squamous cell carcinoma in 32 cases, of adenocarcinoma in 2; tumour in the upper third of the oesophagus in 11 (32.5%), in the middle third in 18 (53%), in the lower third in 5 (14.5%); male/female ratio 29/5, age 48-68 years (mean 56), Karnofsky performance status of 60% or higher.
  • Twenty-one had Stage III (61.75%) and 13 stage IV (38.25%) cancer, with metastasis limited to the supraclavicular or coeliac nodes, which could be included in the radiation volume.
  • In all cases chemotherapy consisted of 5-Fluoruracil (administered in a continuous i.v. infusion, from day 1 to 5, with a 750-1.000 mg/n.sq daily dose) and Cisplatin (75-100 mg/n.sq on the first day, or 20 mg/n.sq for 5 consecutive daily doses, administered by i.v. bolus).
  • Irradiation started with the first cycle of chemotherapy in 5 patients, with the second or third cycle in 29.
  • At least two cycles of chemotherapy were administered during the course of radiation.
  • Radiotherapy was performed with 4 to 18 MeV linear accelerator X-rays, or telecobalt, through opposite anterior and posterior treatment portals or more complex field arrangements.
  • The doses were in the range of 44-66 Gy, with fractionation of 5x180-200 cGy weekly sessions.
  • After treatment, periodic follow-up controls were carried out in all cases.
  • Data on improvement of swallowing were always available, however, and the early therapeutic results were analysed accordingly.
  • Two-year survival after conclusion of the treatment was calculated according to Kaplan and Maier.
  • Survival was analysed (log-rank test) according to stage, Performance Status, oesophagectomy and body weight loss.
  • RESULTS: After treatment, subjective symptomatic relief occurred in 17 of the 22 patients presenting dysphagia (77.5%).
  • Acute toxicity (Grade III or IV WHO) of the treatment accounted for 47% of hematologic adverse effects, 40% of mucositis, 20.5% of vomiting or diarrhoea not responding to drug treatment.
  • Treatment delays of more than one week, due to toxicity, occurred in 23.5%.
  • Overall 2 year survival was 13%, with a median value of 10 months.
  • Survival analysis, according to stage, showed 2 year values of 24% in Stage III and 0% in Stage IV (p=0.09).
  • Six patients showed a remarkable improvement in symptoms and general conditions after treatment, and were restaged with oesophagoscopy, thoracic CT scan and bronchoscopy, which evidenced resectable residual tumors, and they were then operated.
  • DISCUSSION AND CONCLUSIONS: Many Stage III and IV patients, selected for an aggressive chemo-radiation approach on the grounds of satisfactory medical conditions, can obtain relief of dysphagia.
  • Some cases, without extrathoracic spread of the tumor can achieve long term survival (in our experience 24% 2-year survival in Stage III, in our experience which favourably compares with the results obtained by other authors).
  • Whether surgery may improve the therapeutic results of chemo-radiotherapy in patients whose tumour has become resectable, is an issue that cannot be satisfactorily addressed on the basis of our experience, nor are the results from the available literature exhaustive to this regard.
  • [MeSH-major] Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Staging

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  • (PMID = 11677442.001).
  • [ISSN] 0033-8362
  • [Journal-full-title] La Radiologia medica
  • [ISO-abbreviation] Radiol Med
  • [Language] ita
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Italy
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8. Yano M, Shiozaki H, Tsujinaka T, Inoue M, Doki Y, Fujiwara Y, Monden M: Squamous cell carcinoma of the esophagus infiltrating the respiratory tract is less sensitive to preoperative concurrent radiation and chemotherapy. J Am Coll Surg; 2000 Dec;191(6):626-34
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  • [Title] Squamous cell carcinoma of the esophagus infiltrating the respiratory tract is less sensitive to preoperative concurrent radiation and chemotherapy.
  • BACKGROUND: The prognosis of upper thoracic esophageal cancer is poor when compared with middle and lower thoracic esophageal cancer because the tumor easily infiltrates the respiratory tract and surgical en-bloc resection is difficult.
  • Recently, preoperative chemoradiation therapy has been shown to lead to down-staging of the disease and improve prognosis.
  • But the benefit of this therapy for tumors infiltrating the respiratory tract remains unknown.
  • STUDY DESIGN: Fifty-six patients with thoracic esophageal cancer infiltrating neighboring organs, but with no hematogeneous metastasis, were given preoperative concurrent chemotherapy (5-fluorouracil and cisplatin) and radiation (40 Gy) therapy.
  • Histologic effectiveness (8.3%, 50.0%, and 41.7% versus 25.0%, 70.0%, and 5.0% in grade 3, grade 2, and grade 1, respectively, for patients with respiratory tract invasion versus those without it, p = 0.0189) and histologic stages (8.3%, 8.3%, 8.3%, 8.3%, 25.0%, and 41.7% versus 20.0%, 0%, 15.0%, 25.0%, 40.0%, and 0% in pathologic CR, stage I, stage IIA, stage IIB, stage III, and stage IV, respectively, for patients with respiratory tract invasion versus those without it, p = 0.0496) were significantly better in patients negative for respiratory tract invasion; the percentages of patients with lymph node metastasis did not differ significantly between the two groups.
  • CONCLUSIONS: Because the prognosis of patients with thoracic esophageal cancer infiltrating the respiratory tract is extremely poor, partially because of the low local effectiveness of preoperative concurrent chemotherapy and radiation therapy, caution is needed when deciding on salvage surgery.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / secondary. Carcinoma, Squamous Cell / therapy. Drug Tolerance. Esophageal Neoplasms / pathology. Esophagectomy. Preoperative Care / methods. Radiation Tolerance. Respiratory Tract Neoplasms / secondary. Respiratory Tract Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Lymph Node Excision. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Recurrence, Local / pathology. Neoplasm Staging. Prognosis. Proportional Hazards Models. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 11129811.001).
  • [ISSN] 1072-7515
  • [Journal-full-title] Journal of the American College of Surgeons
  • [ISO-abbreviation] J. Am. Coll. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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9. Albregts M, Hulshof MC, Zum Vörde Sive Vörding PJ, van Lanschot JJ, Richel DJ, Crezee H, Fockens P, van Dijk JD, González González D: A feasibility study in oesophageal carcinoma using deep loco-regional hyperthermia combined with concurrent chemotherapy followed by surgery. Int J Hyperthermia; 2004 Sep;20(6):647-59
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  • [Title] A feasibility study in oesophageal carcinoma using deep loco-regional hyperthermia combined with concurrent chemotherapy followed by surgery.
  • This phase I-II study investigated the feasibility of external deep loco-regional hyperthermia in localized primarily operable carcinoma of the thoracic oesophagus and gastro-oesophageal junction.
  • Toxicity when combining neo-adjuvant hyperthermia with concurrent chemotherapy (CDDP and etoposide) was evaluated.
  • Hyperthermia was given with a four antenna array, operating at 70 MHz arranged around the thorax.
  • Temperatures were monitored rectally, intra-oesophageal at tumour level and intramuscular near the spine.
  • In four steps, a thermal dose escalation was performed from 15-60 min of heating to 41 degrees C with two patients in each step.
  • The combined treatment courses were repeated every 3 weeks for a maximum of four courses.
  • Pre-treatment tumour stage mainly consisted of T3N1 (stage III) tumours, with a mean length of 6 cm.
  • Combined hyperthermia and chemotherapy was given 55 times in 26 patients.
  • The amplitude was set at a ratio between top:bottom:left:right = 1:3:3:3, with a power range of 800-1000 W.
  • Twenty-two patients underwent oesophageal-cardia resection with gastric tube reconstruction.
  • There was no report of complications in the post-operative phase, which could be contributed to either the prior chemotherapy or the hyperthermia.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Esophageal Neoplasms / therapy. Hyperthermia, Induced / methods
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / surgery. Adenocarcinoma / therapy. Adult. Aged. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / surgery. Carcinoma, Squamous Cell / therapy. Cisplatin / administration & dosage. Cisplatin / adverse effects. Combined Modality Therapy. Etoposide / administration & dosage. Etoposide / adverse effects. Feasibility Studies. Female. Humans. Male. Middle Aged. Neoplasm Staging. Patient Selection. Survival Rate. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 15370820.001).
  • [ISSN] 0265-6736
  • [Journal-full-title] International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group
  • [ISO-abbreviation] Int J Hyperthermia
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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10. Zhang MY, Wang Z, Liu XY, Chen G, Liu FY: [The local control of radiotherapy following Ivor-Lewis esophagectomy in the patients with stage II A middle-third thoracic esophageal cancer]. Zhonghua Wai Ke Za Zhi; 2008 Jul 15;46(14):1048-50
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  • [Title] [The local control of radiotherapy following Ivor-Lewis esophagectomy in the patients with stage II A middle-third thoracic esophageal cancer].
  • OBJECTIVE: To investigate the local control of radiotherapy following Ivor-Lewis esophagectomy in the patients with stage IIA middle-third thoracic esophageal cancer.
  • METHODS: From June 1999 to June 2002, 125 patients with stage IIA squamous cell carcinoma of the middle-third thoracic esophagus were treated with Ivor-Lewis esophagectomy with two-fields lymphadenectomy.
  • Of all cases of recurrence, 38 patients (30.4%) developed locoregional recurrence (including 5 patients with locoregional and hematogenous recurrence simultaneously).
  • The locoregional recurrence rate of patients who received postoperative radiotherapy (20.3%) was significantly lower than that of both the group who received adjunctive chemotherapy (40.6%) and the group without adjunctive therapy (41.4%) (P < 0.05).
  • Radiotherapy following Ivor-Lewis esophagectomy is an effective strategy to control local recurrence of the stage II A middle-third thoracic esophageal cancer.
  • [MeSH-major] Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / surgery. Esophagectomy / methods. Radiotherapy, Adjuvant

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  • (PMID = 19094527.001).
  • [ISSN] 0529-5815
  • [Journal-full-title] Zhonghua wai ke za zhi [Chinese journal of surgery]
  • [ISO-abbreviation] Zhonghua Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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11. Matsutani T, Sasajima K, Maruyama H, Suzuki S, Miyamoto M, Yokoyama T, Yanagi K, Matsushita A, Matsuda A, Tajiri T: [A case of the oldest old patient with advanced esophageal cancer responding completely to the combination chemotherapy of docetaxel/5-fluorouracil/nedaplatin with radiation]. Nihon Shokakibyo Gakkai Zasshi; 2009 Jul;106(7):1026-30
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  • [Title] [A case of the oldest old patient with advanced esophageal cancer responding completely to the combination chemotherapy of docetaxel/5-fluorouracil/nedaplatin with radiation].
  • Endoscopic examination revealed an advanced esophageal cancer located in the lower thoracic esophagus.
  • Histological analysis revealed moderately differentiated squamous cell carcinoma.
  • The clinical stage was diagnosed as T2N0M0, stage II.
  • He received radiation therapy in combination with chemotherapy using docetaxel, 5-fluorouracil and nedaplatin.
  • After chemoradiotherapy (CRT), the carcinoma could not be detected by CT or endoscopy, and endoscopic biopsy revealed no cancer cells in categorization as resulting complete response.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Esophageal Neoplasms / drug therapy

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  • (PMID = 19578310.001).
  • [ISSN] 0446-6586
  • [Journal-full-title] Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology
  • [ISO-abbreviation] Nihon Shokakibyo Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents; 0 / Organoplatinum Compounds; 0 / Taxoids; 15H5577CQD / docetaxel; 8UQ3W6JXAN / nedaplatin; U3P01618RT / Fluorouracil
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12. Toita T, Ogawa K, Adachi G, Kakinohana Y, Nishikuramori Y, Iraha S, Utsunomiya T, Murayama S: Concurrent chemoradiotherapy for squamous cell carcinoma of thoracic esophagus: feasibility and outcome of large regional field and high-dose external beam boost irradiation. Jpn J Clin Oncol; 2001 Aug;31(8):375-81
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  • [Title] Concurrent chemoradiotherapy for squamous cell carcinoma of thoracic esophagus: feasibility and outcome of large regional field and high-dose external beam boost irradiation.
  • OBJECTIVE: To assess the feasibility and outcome of concurrent chemoradiotherapy (CT-RT) with large regional field and high-dose external beam boost irradiation in thoracic esophageal cancer.
  • METHODS: Patients with clinical stage T1 (submucosal)-4N0-1M0 (UICC 1997) squamous cell carcinoma of the thoracic esophagus were eligible.
  • Radiotherapy consisted of regional irradiation (extending from supraclavicular fossa to the paracardial area) with 39.6 Gy followed by high-dose external beam boost up to 66.6 Gy (1.8 Gy/day, five times per week).
  • RESULTS: Thirty patients (stage I, 3; stage II, 11; stage III, 16) were entered into the study.
  • Twenty-one patients (70%) completed the planned treatment.
  • The median survival time was 21 months.
  • The incidence of esophageal stricture (grade 1-2: RTOG) was 21%.
  • CONCLUSIONS: Despite poor compliance for elderly patients and frequent severe toxicities, our concurrent CT-RT resulted in a favorable outcome in thoracic esophageal cancer.
  • [MeSH-major] Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Feasibility Studies. Female. Humans. Male. Middle Aged. Radiotherapy Dosage. Radiotherapy, High-Energy. Survival Rate

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  • (PMID = 11574630.001).
  • [ISSN] 0368-2811
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
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13. Jiang YY, Wu SX, Zhang P, Xie CY, Wang J, Sun CC: [Concurrent standard dose of cisplatin, paclitaxel, and radiotherapy followed by surgery in treatment of thoracic esophageal carcinoma]. Zhonghua Yi Xue Za Zhi; 2008 Aug 12;88(31):2171-4
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  • [Title] [Concurrent standard dose of cisplatin, paclitaxel, and radiotherapy followed by surgery in treatment of thoracic esophageal carcinoma].
  • OBJECTIVE: To investigate the curative effect of incorporation of the regimen of standard dose of paclitaxel combined with cisplatin into concurrent radiotherapy as pre-operative treatment for patients with esophageal carcinoma.
  • METHODS: Twenty-six patients with primary diagnosis of esophageal carcinoma, 17 in stage II and 9 in stage III, underwent conventional fractionated radiotherapy with a total dosage of 40 Gy (2 Gy per day, 5 doses per week).
  • 4 - 6 weeks after the completion of chemo-radiotherapy, left thoracic incision and transhiatal esophagectomy with anastomosis in the neck was performed.
  • The pathologic response to chemoradiotherapy were grade I in 9 patients, grade II in 6 patients, and grade III in 11 patients.
  • The 3-year overall survival rates of the patients with different pathologic responses were 25.40% (for those of grade I), 60% (for grade II), and 90.91% (for grade III) respectively (P < 0.05).
  • The 5-year overall survival rates were 0 (for grade I), 60% (for grade II), and 81.82% (for grade III) respectively (P < 0.05).
  • CONCLUSION: Preoperative chemoradiotherapy containing full dose of paclitaxel and cisplatin increases the 5-year overall survival for the patients with postoperative pathologic response grade II and above, and does not increase the treatment-related complications.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / therapy. Esophageal Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Combined Modality Therapy. Drug Administration Schedule. Esophagectomy. Female. Follow-Up Studies. Humans. Kaplan-Meier Estimate. Male. Middle Aged. Paclitaxel / administration & dosage. Radiotherapy. Young Adult

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  • (PMID = 19080664.001).
  • [ISSN] 0376-2491
  • [Journal-full-title] Zhonghua yi xue za zhi
  • [ISO-abbreviation] Zhonghua Yi Xue Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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14. Liao Z, Zhang Z, Jin J, Ajani JA, Swisher SG, Stevens CW, Ho L, Smythe R, Vaporciyan AA, Putnam JB Jr, Walsh GL, Roth JA, Yao JC, Allen PK, Cox JD, Komaki R: Esophagectomy after concurrent chemoradiotherapy improves locoregional control in clinical stage II or III esophageal cancer patients. Int J Radiat Oncol Biol Phys; 2004 Dec 1;60(5):1484-93
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  • [Title] Esophagectomy after concurrent chemoradiotherapy improves locoregional control in clinical stage II or III esophageal cancer patients.
  • PURPOSE: To evaluate the effect of surgical resection on the outcome of patients with clinical Stage II or III cancer of the esophagus treated with concurrent chemoradiotherapy.
  • METHODS AND MATERIALS: A retrospective review of 132 consecutive patients with clinical Stage II or III esophageal cancer treated with concurrent chemoradiotherapy between January 1990 and December 1998 was performed.
  • The median radiation dose was 50 Gy (range, 30-64.8 Gy) in the definitive chemoradiation group and 45 Gy (range, 30-50.4 Gy) in the chemoradiation plus esophagectomy group.
  • Patients who underwent definitive chemoradiotherapy were older (p = 0.0004) and more likely to have squamous cell carcinoma than adenocarcinoma (p <0.000), upper thoracic or cervical esophageal tumors (p <0.000), and T4 tumors (p = 0.024).
  • Patients treated with chemoradiation plus esophagectomy had statistically significant superior 5-year loco-regional control (67.1% vs. 22.1%, p <0.000), disease-free survival (40.7% vs. 9.9%, p < 0.000), and 5-year overall survival (52.6% vs. 6.5%, p < 0.000) rates and median survival time (62 vs. 12 months) compared with patients treated with chemoradiotherapy only.
  • CONCLUSIONS: Locoregional control was better in clinical Stage II or III esophageal cancer patients treated with concurrent chemoradiation plus esophagectomy.
  • The results from this study suggest the need for a randomized trial to compare chemoradiation with or without esophagectomy in the treatment of cancer of the esophagus.
  • [MeSH-major] Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / surgery. Esophagectomy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / pathology. Adenocarcinoma / radiotherapy. Adenocarcinoma / surgery. Adult. Aged. Aged, 80 and over. Analysis of Variance. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neoplasm Staging. Radiotherapy Dosage. Retrospective Studies. Treatment Failure

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  • (PMID = 15590179.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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15. Takemura M, Osugi H, Lee S, Nishikawa T, Fukuhara K, Iwasaki H: [Pathologic complete response of thoracic esophageal cancer developing after gastrectomy to neoadjuvant low-dose nedaplatin (CDGP), 5-fluorouracil and radiotherapy]. Gan To Kagaku Ryoho; 2005 Jul;32(7):1023-7
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  • [Title] [Pathologic complete response of thoracic esophageal cancer developing after gastrectomy to neoadjuvant low-dose nedaplatin (CDGP), 5-fluorouracil and radiotherapy].
  • We treated a 69-year-old man who had developed esophageal cancer following gastrectomy.
  • The cancer located in the middle of the thoracic esophagus, had invaded the trachea and metastasized to cervical lymph nodes according to computed tomography.
  • The esophageal cancer was found by endoscopy to have diminished significantly after completion of neoadjuvant therapy, An endoscopic biopsy specimen was found to contain no malignant cells.
  • Partial response was diagnosed based on imaging, and radical resection of the esophageal cancer was performed via right thoracotomy and laparotomy.
  • Operative staging findings indicated Ch x R-T 3 N 0 M 0, Stage II R 0 D 2 Cur A.
  • Neoadjuvant chemoradiotherapy using low-dose CDGP/5-FU is an effective treatment for esophageal cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy. Gastrectomy
  • [MeSH-minor] Aged. Combined Modality Therapy. Dose-Response Relationship, Drug. Drug Administration Schedule. Fluorouracil / administration & dosage. Humans. Male. Neoadjuvant Therapy. Organoplatinum Compounds / administration & dosage. Remission Induction

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  • (PMID = 16044966.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Organoplatinum Compounds; 8UQ3W6JXAN / nedaplatin; U3P01618RT / Fluorouracil
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16. Fu JH, Rong TH, Li XD, Hu Y, Ou W, Hu YH, Li Q: [Chemoradiotherapy followed by surgery in treatment of locally advanced esophageal carcinoma: a phase II trial]. Ai Zheng; 2004 Nov;23(11 Suppl):1473-6
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  • [Title] [Chemoradiotherapy followed by surgery in treatment of locally advanced esophageal carcinoma: a phase II trial].
  • BACKGROUND & OBJECTIVE: Recently, neoadjuvant therapy has become the focus of interest in an effort to prolong survival and reduce recurrence rates in patients with oesophageal cancer.
  • This study was designed to evaluate the tolerance and the short-term outcome of chemoradiotherapy followed by surgery for patients with locally advanced esophageal squamous carcinoma, to observe effects of chemoradiotherapy on tumor resection rate, incidence of complications after surgery, and perioperative mortality.
  • METHODS: From January 2000 to September 2003, Thirty-four consecutive patients with locally advanced esophageal squamous carcinoma were entered into this phase II study.
  • The clinical pre-treatment staging of the tumors were determined by chest CT scan, abdomial CT Scan, EUS, and bronchoscopy examination.
  • Chemotherapy and radiotherapy were performed concurrently.
  • The chemotherapy consisted of Vinorelbine (or 5-Fluorouracil) and Cisplatin.
  • A total radiotherapy dose of 40 Gy was delivered in 20 daily fractions of 2.0 Gy each (given 5 d/wk for 4 weeks).
  • The toxicities of chemoradiotherapy such as myelotoxicity, pulmonary toxicity, esophagitis were grade I or II.
  • Preoperative chemoradiotherapy is able to significantly reduce the tumor stage, and achieve substantially high clinical response rate and pathological complete response rate.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / therapy. Esophageal Neoplasms / therapy. Esophagectomy
  • [MeSH-minor] Adult. Chemotherapy, Adjuvant. Female. Humans. Male. Middle Aged. Postoperative Complications. Preoperative Care. Radiotherapy Dosage. Radiotherapy, Adjuvant

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  • (PMID = 15566661.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; English Abstract; Journal Article
  • [Publication-country] China
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17. Takemura M, Osugi H, Lee S, Kaneko M, Tanaka Y, Fujiwara Y, Nishizawa S, Iwasaki H, Higashino M: [A resected case of thoracic esophageal cancer in which pCR was obtained using low-dose of nedaplatin (CDGP)/5-FU and radiotherapy]. Gan To Kagaku Ryoho; 2004 Sep;31(9):1399-402
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  • [Title] [A resected case of thoracic esophageal cancer in which pCR was obtained using low-dose of nedaplatin (CDGP)/5-FU and radiotherapy].
  • This is a report of a case with esophageal cancer in which pathological CR was obtained by neoadjvant chemoradiotherapy using a low-dose of nedaplatin (CDGP)/5-FU.
  • A protuberant lesion diagnosed as esophageal cancer was found in the middle thoracic esophagus by esophagography.
  • Since another lesion in the upper thoracic esophagus was revealed by endoscopy, metastasis to the cervical lymph nodes was diagnosed by ultrasonography, and preoperative chemoradiotherapy combining a low dose of CDGP/5-FU with radiotherapy was performed.
  • As side effects of this treatment, grade 2 stomatitis and granulocytopenia were observed.
  • The main lesion of the esophagus was found to have significantly diminished through endoscopy after completion of the treatment, and with no malignant cells obtained by biopsy.
  • Radical resection of esophageal cancer under right thoracotomy and laparotomy was performed.
  • Operative findings were Ch x R-T3N0M0 Stage II R0 D2 Cur A.
  • Neoadjuvant chemoradiotherapy using a low-dose of CDGP/5-FU is an effective treatment for esophageal cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Combined Modality Therapy. Dose-Response Relationship, Drug. Drug Administration Schedule. Esophagectomy. Fluorouracil / administration & dosage. Humans. Male. Organoplatinum Compounds / administration & dosage. Remission Induction

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  • (PMID = 15446565.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Organoplatinum Compounds; 8UQ3W6JXAN / nedaplatin; U3P01618RT / Fluorouracil
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18. Liang Z, Hu WD, Gu ZD, Xiong HC, Chen KN: [Evaluation of transhiatus esophagectomy for patients with esophageal cancer]. Zhonghua Wei Chang Wai Ke Za Zhi; 2008 Sep;11(5):451-3
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  • [Title] [Evaluation of transhiatus esophagectomy for patients with esophageal cancer].
  • OBJECTIVE: To evaluate the transhiatus esophagectomy for patients with esophageal cancer.
  • METHODS: Clinicopathological data of 46 patients with esophageal cancer undergone transhiatus esophagectomy by single surgeon team from May 2000 to July 2007 were analyzed retrospectively.
  • RESULTS: These 46 patients included 44 esophageal squamous cell carcinomas,1 esophageal adenocarcinoma and 1 esophageal carcinoid.
  • All the patients were classified according to UICC TNM stage classification: 3 cases as stage 0, 6 cases as stage I, 17 cases as stage II a, 2 cases as stage II b, 16 cases as stage III.
  • Six patients received preoperative chemotherapy and pathological complete response was seen in 2 cases.
  • CONCLUSION: Transhiatus esophagectomy is an ideal choice in surgical treatment for patients with esophageal cancer, especially for the ones of aged, poor cardiac or pulmonary function, who can not afford the thoracotomy.
  • [MeSH-major] Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / surgery. Esophagectomy / methods

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  • (PMID = 18803048.001).
  • [ISSN] 1671-0274
  • [Journal-full-title] Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery
  • [ISO-abbreviation] Zhonghua Wei Chang Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Evaluation Studies; Journal Article
  • [Publication-country] China
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19. Kang CH, Kim YT, Jeon SH, Sung SW, Kim JH: Lymphadenectomy extent is closely related to long-term survival in esophageal cancer. Eur J Cardiothorac Surg; 2007 Feb;31(2):154-60
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  • [Title] Lymphadenectomy extent is closely related to long-term survival in esophageal cancer.
  • OBJECTIVE: The optimal extent of lymphadenectomy during esophagectomy for esophageal cancer remains debatable.
  • The aim of this study was to identify the effect of the extent of lymphadenectomy on survival and recurrence after esophagectomy in esophageal cancer.
  • MATERIALS AND METHODS: Two hundred thirty-three patients who were operated on between January 1995 and December 2003 due to esophageal cancer were included.
  • The study subjects were stage I, II, and III esophageal squamous cell carcinoma patients who had undergone curative resection without neoadjuvant chemotherapy or chemoradiation therapy.
  • To analyze the extent of lymphadenectomy, lymph node stations were classified into three regions, namely, paraesophageal, upper thoracic, and abdominal regions, and patients were allocated to one of three groups, i.e., group 1 received lymphadenectomy in one region only, group 2 in two regions, and group 3 in three regions.
  • RESULTS: The pathologic stages were stage I in 57 (24.5%), IIA in 69 (29.6%), IIB in 27 (11.6%), and III in 80 (34.3%).
  • CONCLUSIONS: A wider extent of lymphadenectomy in esophageal cancer was associated with better long-term survival than limited lymphadenectomy, especially in N0 patients.
  • [MeSH-major] Carcinoma, Squamous Cell / secondary. Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / surgery. Lymph Node Excision / methods

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  • (PMID = 17145185.001).
  • [ISSN] 1010-7940
  • [Journal-full-title] European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • [ISO-abbreviation] Eur J Cardiothorac Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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20. Sun KL, He J, Cheng GY, Chai LX: Management of primary small cell carcinoma of the esophagus. Chin Med J (Engl); 2007 Mar 5;120(5):355-8
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  • [Title] Management of primary small cell carcinoma of the esophagus.
  • BACKGROUND: Primary small cell carcinoma of the esophagus is rare.
  • Although surgery is successful in eradicating local tumor, the five-year survival rate of patients with primary small cell carcinoma of the esophagus after resection is lower than that of patients with primary squamous cell carcinoma of the esophagus.
  • The purpose of this study was to analyze the clinical manifestations, pathological features and treatment of primary small cell carcinoma of the esophagus.
  • METHODS: A total of 73 patients with primary small cell carcinoma of the esophagus who had been treated by surgery from 1984 to 2003 were analyzed retrospectively.
  • CONCLUSIONS: Primary small cell carcinoma of the esophagus is rare with a poor prognosis.
  • Surgical resection is the leading method for patients with stage I or II primary small cell carcinoma of the esophagus.
  • Postoperative chemotherapy is beneficial to these patients.
  • The patients of stage III or IV should be given chemotherapy and radiation therapy.
  • [MeSH-major] Carcinoma, Small Cell / therapy. Esophageal Neoplasms / therapy

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  • (PMID = 17376302.001).
  • [ISSN] 0366-6999
  • [Journal-full-title] Chinese medical journal
  • [ISO-abbreviation] Chin. Med. J.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China
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21. D'Angelillo RM, Trodella L, Ciresa M, Cellini F, Fiore M, Greco C, Pompeo E, Mineo TC, Paleari L, Granone P, Ramella S, Cesario A: Multimodality treatment of stage III non-small cell lung cancer: analysis of a phase II trial using preoperative cisplatin and gemcitabine with concurrent radiotherapy. J Thorac Oncol; 2009 Dec;4(12):1517-23
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  • [Title] Multimodality treatment of stage III non-small cell lung cancer: analysis of a phase II trial using preoperative cisplatin and gemcitabine with concurrent radiotherapy.
  • INTRODUCTION: We report the results of a phase II trial exploring the efficacy and the feasibility of combination of gemcitabine and cisplatin concurrent with radiotherapy followed by surgery in patients with stage III non-small cell lung cancer.
  • METHODS: Patients with histocytologically confirmed non-small cell lung cancer were treated with cisplatin 80 mg/sqm/wk of 1 and 4 or 20 mg/sqm/d of weeks 1 and 4 and weekly gemcitabine at 300 to 350 mg/m2 plus involved field radiotherapy.
  • A 3D-conformal radiotherapy was delivered up to 50.4 Gy, with daily fractionation of 1.8 Gy.
  • RESULTS: The stage at diagnosis was IIIA-N2 in 29 patients and IIIB-T4N0-2 for vascular direct infiltration for the remaining 21.
  • Fifteen patients (30%) experienced acute grade 3 to 4 hematological toxicity, whereas acute grade 3 esophageal toxicity was recorded in three patients (6%).
  • One patient developed a grade 4 pulmonary toxicity (2%).
  • Final pathology showed a downstaging to stage 0 to I in 25 cases (50%).
  • Median overall survival for all patients was 21.8 months, with a 3-year survival of 40.2%.
  • CONCLUSIONS: The results of this phase II trial confirm the feasibility and the efficacy of concurrent chemoradiotherapy followed by surgery.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Non-Small-Cell Lung / drug therapy. Carcinoma, Non-Small-Cell Lung / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / radiotherapy. Adenocarcinoma / secondary. Adult. Aged. Aged, 80 and over. Carcinoma, Large Cell / drug therapy. Carcinoma, Large Cell / radiotherapy. Carcinoma, Large Cell / secondary. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Carcinoma, Squamous Cell / secondary. Cisplatin / administration & dosage. Combined Modality Therapy. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Dose Fractionation. Feasibility Studies. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Prognosis. Survival Rate. Treatment Outcome

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  • (PMID = 19875976.001).
  • [ISSN] 1556-1380
  • [Journal-full-title] Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
  • [ISO-abbreviation] J Thorac Oncol
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine; Q20Q21Q62J / Cisplatin
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22. Low DE, Kunz S, Schembre D, Otero H, Malpass T, Hsi A, Song G, Hinke R, Kozarek RA: Esophagectomy--it's not just about mortality anymore: standardized perioperative clinical pathways improve outcomes in patients with esophageal cancer. J Gastrointest Surg; 2007 Nov;11(11):1395-402; discussion 1402
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  • [Title] Esophagectomy--it's not just about mortality anymore: standardized perioperative clinical pathways improve outcomes in patients with esophageal cancer.
  • BACKGROUND: Esophageal resection (ER) remains the standard therapy for early esophageal cancer; however, because of concerns regarding high levels of morbidity and mortality reported in analyses of national databases, many patients are relegated to less effective endoscopic or chemotherapeutic approaches.
  • All aspects of work-up and treatment were guided by an evolving standardized perioperative clinical pathway.
  • RESULTS: Three hundred forty consecutive patients, mean age of 64 (33-90), underwent ER for Barrett's esophagus (17) or invasive cancer stages I-87, II-133, III-94, IV-9.
  • One hundred thirty-nine (41%) had neoadjuvant therapy.
  • Patient were managed intraoperatively with a "fluid restriction" protocol.
  • No significant differences were seen in length of stay, operative time, blood loss, or complications in patients receiving neoadjuvant therapy.
  • For stages I, II, and III, patients between 1998-2004 Kaplan-Meier 5-year cumulative survival was 92.4, 57.1, and 34.5%, respectively.
  • CONCLUSIONS: Surgical treatment of esophageal cancer can be done with moderate morbidity and very low mortality, and the expectation of improved levels of survival, especially in early-stage patients.
  • Standardized perioperative clinical pathways can provide the infrastructure for the treatment of these patients and should include increased efforts to minimize blood loss and transfusions, improve postoperative pain control and extubation rates, and facilitate early mobilization and discharge.
  • ER, as sole therapy or in combination with radiation/chemotherapy, should remain the standard of care in patients with early and locoregional esophageal cancer.
  • [MeSH-major] Adenocarcinoma / mortality. Adenocarcinoma / surgery. Carcinoma, Squamous Cell / mortality. Carcinoma, Squamous Cell / surgery. Critical Pathways. Esophageal Neoplasms / mortality. Esophageal Neoplasms / surgery. Esophagectomy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Barrett Esophagus / surgery. Blood Loss, Surgical. Female. Humans. Length of Stay. Male. Middle Aged. Neoadjuvant Therapy. Neoplasm Staging. Prognosis. Treatment Outcome

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  • (PMID = 17763917.001).
  • [ISSN] 1091-255X
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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23. Takemura M, Osugi H, Lee S, Taguchi S, Kaneko M, Tanaka Y, Fukuhara K, Fujiwara Y, Nishizawa S, Kinoshita H, Harada S: [A case of synchronous esophageal and gastric cancer successfully treated by combination TS-1/CDDP therapy with irradiation]. Gan To Kagaku Ryoho; 2004 Feb;31(2):251-4
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  • [Title] [A case of synchronous esophageal and gastric cancer successfully treated by combination TS-1/CDDP therapy with irradiation].
  • We report a case of synchronous esophageal and gastric cancer in a patient with severe liver dysfunction who was treated successfully using TS-1/CDDP therapy combined with irradiation therapy.
  • A 56-year-old man with a chief complaint of dysphagia was diagnosed with thoracic esophageal cancer by endoscopy, and was referred to our hospital.
  • Synchronous esophageal and gastric cancer were diagnosed by endoscopy and barium swallow.
  • The preoperative diagnosis was T3N0M0, Stage II esophageal cancer and T1N0M0, Stage I A gastric cancer, both of which were diagnosed to be resectable.
  • TS-1 (80 mg/day) and CDDP (3 mg/day) therapy was combined with irradiation, 60 Gy given in a T-pattern to the mediastinum.
  • The patient did not suffer any side-effects, and endoscopy performed 44 days after the start of treatment showed that the esophageal lesion was now only a scar.
  • Only a slight elevation of the esophagus was seen by endoscopy 219 days after the start of the therapy.
  • The patient is currently undergoing only TS-1 treatment as an outpatient and is under observation.
  • TS-1 and CDDP therapy combined with radiotherapy appears to be effective in treating thoracic esophageal cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy. Neoplasms, Multiple Primary. Stomach Neoplasms / drug therapy. Stomach Neoplasms / radiotherapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / radiotherapy. Administration, Oral. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Cisplatin / administration & dosage. Combined Modality Therapy. Drug Administration Schedule. Drug Combinations. Humans. Male. Middle Aged. Oxonic Acid / administration & dosage. Pyridines / administration & dosage. Radiotherapy Dosage. Tegafur / administration & dosage

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  • (PMID = 14997762.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Drug Combinations; 0 / Pyridines; 150863-82-4 / S 1 (combination); 1548R74NSZ / Tegafur; 5VT6420TIG / Oxonic Acid; Q20Q21Q62J / Cisplatin
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24. Socinski MA: Antibodies to the epidermal growth factor receptor in non small cell lung cancer: current status of matuzumab and panitumumab. Clin Cancer Res; 2007 Aug 1;13(15 Pt 2):s4597-601
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  • [Title] Antibodies to the epidermal growth factor receptor in non small cell lung cancer: current status of matuzumab and panitumumab.
  • Matuzumab and panitumumab are antibodies against the epidermal growth factor receptor (EGFR) that are being evaluated in several malignancies including non-small cell lung cancer (NSCLC).
  • In phase I trials of single-agent matuzumab in patients with EGFR-positive cancer, three tumor responses were documented in esophageal squamous cell carcinoma as well as colorectal carcinoma.
  • A randomized phase II trial is currently ongoing in second-line NSCLC with matuzumab in combination with pemetrexed.
  • A randomized phase II trial of carboplatin/paclitaxel with or without panitumumab in 166 patients with previously untreated advanced stage IIIB/IV NSCLC did not find any benefit for the panitumumab arm compared with the chemotherapy alone arm with regard to response rates, time to disease progression, or median survival time.
  • The lack of a biomarker to identify a subset of NSCLC patients who may derive benefit from this agent limits any potential enthusiasm for further trials of panitumumab at this time in NSCLC.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Antineoplastic Agents / therapeutic use. Carcinoma, Non-Small-Cell Lung / drug therapy. Lung Neoplasms / drug therapy. Receptor, Epidermal Growth Factor / immunology
  • [MeSH-minor] Animals. Antibodies, Monoclonal, Humanized. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Clinical Trials as Topic. Humans


25. Adelstein DJ, Rice TW, Rybicki LA, Saxton JP, Videtic GM, Murthy SC, Mason DP, Rodriguez CP, Ives DI: Mature results from a phase II trial of postoperative concurrent chemoradiotherapy for poor prognosis cancer of the esophagus and gastroesophageal junction. J Thorac Oncol; 2009 Oct;4(10):1264-9
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  • [Title] Mature results from a phase II trial of postoperative concurrent chemoradiotherapy for poor prognosis cancer of the esophagus and gastroesophageal junction.
  • INTRODUCTION: Mature results are presented from a phase II trial of postoperative concurrent chemoradiotherapy in patients with poor-prognosis cancer of the esophagus and gastroesophageal junction after primary surgical resection.
  • METHODS: Resected patients with a pathologic stage of T3, N1, or M1a were eligible for this trial.
  • Concurrent chemoradiotherapy was begun between 6 and 10 weeks after surgery and consisted of radiotherapy (1.8 Gy/d to a planned dose of 50.4-59.4 Gy), concurrent with two cycles of 5-fluorouracil (1000 mg/m/d) and cisplatin (20 mg/m/d), both given as 4-day continuous intravenous infusions during the first and fourth weeks of the radiation.
  • With a median follow-up of 47 (range, 36-124) months, the Kaplan-Meier 4-year projected overall survival is 51%, freedom from recurrence 50%, distant metastatic control 56%, and locoregional control 86%.
  • An earlier pathologic stage was the only predictor for a better outcome.
  • CONCLUSIONS: This schedule of postoperative concurrent chemoradiotherapy has acceptable toxicity for patients with poor-prognosis esophageal and gastroesophageal junction cancer after surgery.
  • [MeSH-major] Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy. Esophagogastric Junction / pathology. Stomach Neoplasms / drug therapy. Stomach Neoplasms / radiotherapy
  • [MeSH-minor] Adenocarcinoma / pathology. Adenocarcinoma / therapy. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / therapy. Cisplatin / administration & dosage. Esophagectomy. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neoplasm Staging. Postoperative Period. Prospective Studies. Radiotherapy Dosage. Survival Rate. Treatment Outcome

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  • (PMID = 19668013.001).
  • [ISSN] 1556-1380
  • [Journal-full-title] Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
  • [ISO-abbreviation] J Thorac Oncol
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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26. Suntharalingam M, Moughan J, Coia LR, Krasna MJ, Kachnic L, Haller DG, Willett CG, John MJ, Minsky BD, Owen JB, 1996-1999 Patterns of Care Study: The national practice for patients receiving radiation therapy for carcinoma of the esophagus: results of the 1996-1999 Patterns of Care Study. Int J Radiat Oncol Biol Phys; 2003 Jul 15;56(4):981-7
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  • [Title] The national practice for patients receiving radiation therapy for carcinoma of the esophagus: results of the 1996-1999 Patterns of Care Study.
  • PURPOSE: A Patterns of Care Study (PCS) was conducted to evaluate the standards of practice for patients receiving radiation therapy for esophageal cancer from 1996 to 1999.
  • This study examined the evaluation and treatment schemes used during this time and compared these results to the PCS data obtained between 1992 and 1994 to identify any fundamental changes in national practice.
  • METHODS: A national survey was conducted using a two-stage cluster sampling technique.
  • Specific information was collected on 414 patients with esophageal cancer who received radiotherapy (RT) as part of definitive or adjuvant management at 59 institutions.
  • Eligibility criteria for case review included RT between 1996 and 1999, no evidence of distant metastasis (including CT evidence of either supraclavicular or celiac nodes >1 cm), squamous cell or adenocarcinoma histology, Karnofsky performance status >60, tumors in the thoracic esophagus with <2 cm extension into the stomach, and no prior malignancies within the last 5 years.
  • Statistical analysis was performed on the database using SUDAAN software to accurately reflect the type of sampling technique used by PCS.
  • For the purposes of comparison, the 1992-1994 PCS esophageal survey results were subjected to the same statistical procedures and tests.
  • A review of the histology revealed a nearly 50:50 split between squamous cell and adenocarcinoma.
  • Sixteen percent were clinical Stage I, 39% clinical Stage II, and 33% clinical Stage III according to the 1983 AJCC system.
  • Fifty-six percent of patients received concurrent chemoradiation as definitive treatment.
  • Forty-six percent of patients with adenocarcinoma underwent trimodality therapy as compared to 19% with squamous cell carcinomas (p = 0.0002).
  • The median total dose of external RT was 50.4 Gy, and the median dose per fraction was 1.8 Gy.
  • The chemotherapy agents most commonly used included 5-fluorouracil (82%), cisplatin (67%), and paclitaxel (22%).
  • Paclitaxel was more commonly employed as part of a preoperative chemoradiation regimen than in the setting of definitive chemoradiation (46% vs. 12%, p = 0.03).
  • CONCLUSIONS: The Patterns of Care Survey confirms the use of concurrent chemoradiation as part of the national standards of practice for the management of esophageal cancer patients.
  • [MeSH-major] Adenocarcinoma / radiotherapy. Benchmarking. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / radiotherapy. Practice Patterns, Physicians'

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  • (PMID = 12829133.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA65435
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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27. Rice DC, Correa AM, Vaporciyan AA, Sodhi N, Smythe WR, Swisher SG, Walsh GL, Putnam JB Jr, Komaki R, Ajani JA, Roth JA: Preoperative chemoradiotherapy prior to esophagectomy in elderly patients is not associated with increased morbidity. Ann Thorac Surg; 2005 Feb;79(2):391-7; discussionn 391-7
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  • BACKGROUND: Preoperative chemotherapy and radiation therapy are often administered to patients with esophageal cancer.
  • Despite an aging population, little data exist regarding feasibility of preoperative therapy in elderly patients.
  • METHODS: Between January 1997 and December 2002, 312 consecutive patients underwent esophagectomy for esophageal cancer at our institution.
  • Outcomes of patients 70 years old, who underwent preoperative therapy (n = 35; group II), were compared with those of patients who did not (n = 39; group I) and with those of patients younger than 70 years old who received preoperative therapy (n = 165; group III).
  • RESULTS: The median age was 75 years old for group I and 72 years for group II (p < 0.001).
  • The patients in group II were of more advanced clinical stage (p < 0.001).
  • Similar proportions of patients in the groups I and II underwent a transhiatal approach (52.5% vs 42.8%, p = not significant [NS]).
  • Perioperative mortality for groups I and II was 0% and 3%, respectively (p = NS).
  • Group II received more perioperative blood transfusions (71.4% vs 48.7%, p = 0.047).
  • Compared with group III, group II patients had higher rates of postoperative atrial arrhythmias (p = 0.013) and perioperative blood transfusions (p = 0.004).
  • CONCLUSIONS: Elderly patients receiving preoperative therapy for esophageal cancer do not have an increased incidence of major postoperative complications.
  • Elderly patients receiving preoperative therapy are more likely to develop postoperative atrial arrhythmias and require transfusion than younger patients.
  • [MeSH-major] Esophageal Neoplasms / epidemiology. Esophageal Neoplasms / surgery. Esophagectomy / methods. Premedication
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / epidemiology. Adenocarcinoma / radiotherapy. Adenocarcinoma / surgery. Age Factors. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Awards and Prizes. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / epidemiology. Carcinoma, Squamous Cell / radiotherapy. Carcinoma, Squamous Cell / surgery. Cardiovascular Diseases / epidemiology. Chemotherapy, Adjuvant. Comorbidity. Diabetes Mellitus, Type 1 / epidemiology. Female. Follow-Up Studies. Humans. Length of Stay / statistics & numerical data. Male. Multivariate Analysis. Neoplasm Staging. Pulmonary Disease, Chronic Obstructive / epidemiology. Radiotherapy, Adjuvant. Renal Insufficiency / epidemiology. Retrospective Studies. Survival Rate

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  • (PMID = 15680801.001).
  • [ISSN] 1552-6259
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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28. Coia LR, Minsky BD, Berkey BA, John MJ, Haller D, Landry J, Pisansky TM, Willett CG, Hoffman JP, Owen JB, Hanks GE: Outcome of patients receiving radiation for cancer of the esophagus: results of the 1992-1994 Patterns of Care Study. J Clin Oncol; 2000 Feb;18(3):455-62
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PURPOSE: A Patterns of Care Study examined the records of patients with esophageal cancer (EC) treated with radiation in 1992 through 1994 to determine the national practice processes of care and outcomes and to compare the results with those of clinical trials.
  • PATIENTS AND METHODS: A national survey of 63 institutions was conducted using two-stage cluster sampling, and specific information was collected on 400 patients with squamous cell (62%) or adenocarcinoma (37%) of the thoracic esophagus who received radiation therapy (RT) as part of primary or adjuvant treatment.
  • Fifteen percent of patients had clinical stage (CS) I disease, 40% had CS II disease, and 30% had CS III disease.
  • Seventy-five percent of patients received chemotherapy; 84% of these received concurrent chemotherapy and radiation (CRT).
  • RESULTS: Significant variables for overall survival in multivariate analysis include the use of esophagectomy (risk ratio [RR] = 0.62), the use of chemotherapy (RR = 0.63), Karnofsky performance status (KPS) greater than 80 (RR = 0.61), CS I or II disease (RR = 0.66), and facility type (RR = 0.72).
  • Preoperative CRT resulted in a nonsignificantly higher 2-year survival rate compared with definitive CRT alone (63% v 39%; P =.11), whereas 2-year survival by planned treatment rather than treatment given was 47.7% for preoperative CRT and 35.4% for definitive CRT (P =.23).
  • Definitive CRT compared with definitive RT alone resulted in significantly higher 2-year survival (39% v 20.6%; P =.027) and lower 2-year local regional failure (30% v 57.9%; P =. 0031).
  • CONCLUSION: This study confirms the value of CRT in EC treatment.
  • [MeSH-major] Adenocarcinoma / radiotherapy. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Clinical Trials as Topic. Cluster Analysis. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / pathology. Survival Analysis. Treatment Outcome

  • MedlinePlus Health Information. consumer health - Esophageal Cancer.
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  • [CommentIn] J Clin Oncol. 2000 Feb;18(3):453-4 [10653859.001]
  • (PMID = 10653860.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Multicenter Study
  • [Publication-country] United States
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29. Swisher SG, Pisters PW, Komaki R, Lahoti S, Ajani JA: Gastroesophageal junction adenocarcinoma. Curr Treat Options Oncol; 2000 Dec;1(5):387-98
MedlinePlus Health Information. consumer health - Esophageal Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The incidence rate of adenocarcinoma of the esophagogastric junction (AEG) is increasing in association with the epidemiologic rise in distal esophageal adenocarcinoma and gastric cardial (AEG type III) tumors.
  • The overall survival rate is poor in most patients with AEG because lymph node or visceral metastases are frequently present at the time patients become symptomatic.
  • Early stage AEG (T1N0 or T2NO, carcinoma in situ, or severe dysplasia ) can in many instances be cured with surgery alone.
  • Ablative treatments for early stage AEG, including endoscopic fulguration by cautery and laser or photodynamic therapy, are investigational at this time.
  • Locoregionally advanced AEG (T3, T4, N1, or M1a ) without distant systemic metastases (M1b) has a poor overall survival rate with surgery alone or definitive chemotherapy and radiation therapy without surgery.
  • Analysis of the use of multimodality treatment strategies for locoregionally advanced AEG types I and II have demonstrated improved survival rates in two small phase III trials with preoperative concurrent chemoradiotherapy followed by surgical resection.
  • In contrast, three small phase III trials with preoperative concurrent or sequential chemoradiotherapy in patients with predominantly squamous cell carcinoma did not demonstrate any clear survival advantage.
  • Additionally, a randomized phase III study evaluating preoperative chemotherapy without radiation therapy in esophageal cancer (predominantly adenocarcinoma) has demonstrated no survival benefit.
  • At the present time, preoperative chemoradiotherapy remains investigational.
  • For locoregionally advanced gastric adenocarcinoma, including AEG type III, postoperative concurrent 5-fluorouracil (5-FU)-based chemoradiotherapy is associated with improved survival as demonstrated in a recently completed random assignment trial (INT 0116).
  • As a result, surgery with postoperative chemoradiotherapy has recently become the standard of care for patients with AJCC stage II and III gastric adenocarcinoma (including patients with AEG type III).
  • Metastatic AEG (M1b) should be treated with palliative chemotherapy (in good performance patients) or supportive care (poor performance) in asymptomatic patients.
  • Radiation therapy and endoscopic stent placement (expandable wire mesh) can be used to palliate dysphagia in patients with M1b disease.
  • [MeSH-major] Adenocarcinoma / therapy. Esophageal Neoplasms / therapy. Esophagogastric Junction / pathology
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Esophagectomy. Humans. Neoplasm Staging. Radiotherapy

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  • (PMID = 12057146.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 47
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