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1. Markogiannakis H, Theodorou D, Toutouzas KG, Larentzakis A, Pattas M, Bousiotou A, Papacostas P, Filis K, Katsaragakis S: Small cell carcinoma arising in Barrett's esophagus: a case report and review of the literature. J Med Case Rep; 2008;2:15

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  • [Title] Small cell carcinoma arising in Barrett's esophagus: a case report and review of the literature.
  • INTRODUCTION: Gastrointestinal tract small cell carcinoma is an infrequent and aggressive neoplasm that represents 0.1-1% of gastrointestinal malignancies.
  • Very few cases of small cell esophageal carcinoma arising in Barrett's esophagus have been reported in the literature.
  • An extremely rare case of primary small cell carcinoma of the distal third of the esophagus arising from dysplastic Barrett's esophagus is herein presented.
  • Esophagogastroscopy revealed an ulceroproliferative, intraluminar mass in the distal esophagus obstructing the esophageal lumen.
  • Biopsy showed small cell esophageal carcinoma.
  • Contrast-enhanced chest and abdominal computed tomography demonstrated a large tumor of the distal third of the esophagus without any lymphadenopathy or distant metastasis.
  • Preoperative chemotherapy with cisplatine and etoposide for 3 months resulted in a significant reduction of the tumor.
  • Histopathology revealed a primary small cell carcinoma of the distal third of the esophagus arising from dysplastic Barrett's esophagus.
  • The patient received another 3 month course of postoperative chemotherapy with the same agents and remained free of disease at 12 month review.
  • CONCLUSION: Although small cell esophageal carcinoma is rare and its association with dysplastic Barrett's esophagus is extremely infrequent, the high carcinogenic risk of Barrett's epithelium should be kept in mind.
  • Prognosis is quite unfavorable; a better prognosis might be possible with early diagnosis and treatment strategies incorporating chemotherapy along with oncological radical surgery and/or radiotherapy as part of a multimodality approach.
  • Since treatment protocols are not well established due to the rarity of the neoplasm, multi-institutional studies are needed to obtain sufficiently large populations for investigation and optimization of therapy of the disease.

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  • (PMID = 18211708.001).
  • [ISSN] 1752-1947
  • [Journal-full-title] Journal of medical case reports
  • [ISO-abbreviation] J Med Case Rep
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2263060
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2. Michalet V, Gaudin JL, Bancel B, El Khaddari S, Baulieux J, Rode A, Souquet JC: [Squamous cell carcinoma of the celiac area. Report of a case and review of the literature]. Gastroenterol Clin Biol; 2002 Dec;26(12):1168-71
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  • [Title] [Squamous cell carcinoma of the celiac area. Report of a case and review of the literature].
  • Primary squamous cell carcinoma of the pancreas or of the stomach is rare and represents a controversial entity.
  • The unusual case of a 50-year-old woman with a large squamous cell carcinoma located in the celiac area and involving liver, stomach and pancreas, is reported here.
  • The microscopic diagnosis was well-differentiated squamous cell carcinoma without glandular structure.
  • Following the procedure, search for another possible primary lesion (esophagus, anus, colon, lung, head and neck, pelvic floor) was performed.
  • In this context, final diagnosis was primary gastric or pancreatic squamous cell carcinoma.
  • Subsequent radiation combined with chemotherapy was instituted, allowing complete remission.
  • Pathogenesis of gastric as well as pancreatic primary squamous cell carcinoma remains obscure and controversial.
  • [MeSH-major] Carcinoma, Squamous Cell. Liver Neoplasms. Neoplasms, Multiple Primary. Pancreatic Neoplasms. Stomach Neoplasms
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Cisplatin / therapeutic use. Female. Humans. Middle Aged. Neoadjuvant Therapy / methods. Neoplasm Recurrence, Local / pathology. Treatment Outcome

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  • (PMID = 12520205.001).
  • [ISSN] 0399-8320
  • [Journal-full-title] Gastroentérologie clinique et biologique
  • [ISO-abbreviation] Gastroenterol. Clin. Biol.
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
  • [Number-of-references] 15
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3. Hamilton K, Chiappori A, Olson S, Sawyers J, Johnson D, Washington K: Prevalence and prognostic significance of neuroendocrine cells in esophageal adenocarcinoma. Mod Pathol; 2000 May;13(5):475-81
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  • We studied neuroendocrine differentiation in esophageal adenocarcinomas and associated Barrett's esophagus (BE) to determine association with patient outcome.
  • Medical records were reviewed for tumor stage, response to therapy, and patient survival.
  • Thirty-two patients received radiation and chemotherapy, and four received radiation.
  • Tumors with CG-positive cells were moderately to poorly differentiated, and many consisted of large cribriform glands, similar to intestinal-type adenocarcinomas.
  • One case of small cell carcinoma of the esophagus was weakly CG positive; another was negative.
  • There was no difference in tumor stage at surgery or survival time between CG-positive and CG-negative tumors.
  • [MeSH-major] Adenocarcinoma / pathology. Carcinoma, Neuroendocrine / pathology. Esophageal Neoplasms / pathology
  • [MeSH-minor] Barrett Esophagus / metabolism. Barrett Esophagus / pathology. Cell Differentiation. Chromogranins / analysis. Humans. Immunohistochemistry. Neoplasm Staging. Neurosecretory Systems / pathology. Prevalence. Prognosis. Survival Analysis. Tennessee / epidemiology

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  • (PMID = 10824917.001).
  • [ISSN] 0893-3952
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 68485
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Chromogranins
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4. Power DG, Ilson DH: Integration of targeted agents in the neo-adjuvant treatment of gastro-esophageal cancers. Ther Adv Med Oncol; 2009 Nov;1(3):145-65
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  • [Title] Integration of targeted agents in the neo-adjuvant treatment of gastro-esophageal cancers.
  • For localized gastric/gastro-esophageal junction (GEJ) cancer there are conflicting data that a peri-operative approach with cisplatin-based chemotherapy improves survival, with the benefits seen in esophageal cancer likely less than a 5-10% incremental improvement.
  • Further trends toward improvement in local control and survival, when combined chemotherapy and radiation therapy are given pre-operatively, are suggested by recent phase III trials.
  • In esophageal/GEJ cancer, definitive chemoradiation is now considered in medically inoperable patients.
  • In squamous cell carcinoma of the esophagus, surgery after primary chemoradiation is not clearly associated with an improved overall survival, however, local control may be better.
  • In localized gastric/GEJ cancer, the integration of bevacizumab with pre-operative chemotherapy is being explored in large randomized studies, and with chemoradiotherapy in pilot trials.
  • The addition of anti-epidermal growth factor receptor and anti-human epidermal growth factor receptor-2 antibody treatment to pre-operative chemoradiation continues to be explored.
  • Early results show the integration of targeted therapy is feasible.
  • Metabolic imaging can predict early response to pre-operative chemotherapy and biomarkers may further predict response to pre-operative chemo-targeted therapy.
  • For T3 or node-positive disease, surgery alone is no longer considered appropriate and neo-adjuvant therapy is recommended.
  • The future of neo-adjuvant strategies in this disease will involve the individualization of therapy with the integration of molecular signatures, targeted therapy, metabolic imaging and predictive biomarkers.

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  • (PMID = 21789119.001).
  • [ISSN] 1758-8359
  • [Journal-full-title] Therapeutic advances in medical oncology
  • [ISO-abbreviation] Ther Adv Med Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC3126001
  • [Keywords] NOTNLM ; bevacizumab / cetuximab / chemotherapy / esophageal carcinoma / radiation / trastuzumab
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5. Shimakawa T, Naritaka Y, Asaka S, Isohata N, Yamaguchi K, Murayama M, Konno S, Katsube T, Ogawa K, Ide H: A case of esophageal cancer with multiple lymph node metastases which responded to neoadjuvant chemotherapy (DCF therapy). Anticancer Res; 2010 Jan;30(1):221-6
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  • [Title] A case of esophageal cancer with multiple lymph node metastases which responded to neoadjuvant chemotherapy (DCF therapy).
  • Therefore, effective neoadjuvant adjuvant treatment is necessary to achieve successful radical resection.
  • The use of neoadjuvant chemotherapy of docetaxel, cisplatin (CDOP) and 5-fluorouracil (5-FU) (DCF) in an advanced case is reported.
  • The patient (a 67-year-old female) was diagnosed with esophageal cancer, T3, N4, M0, stage IVa with a large number of lymph node metastases in the mediastinum and in the abdominal cavity.
  • Neoadjuvant DCF chemotherapy was initiated in August 2006.
  • The surgical procedure included a right thoracolaparotomy followed by a subtotal excision of the esophagus and two-field lymph node dissection.
  • The cancer was diagnosed to be moderately differentiated squamous cell cancer, pT2, pN4(3c) and pstage IVa.
  • The histological efficacy of the chemotherapy was determined to be grade 1a.
  • Two additional courses of DCF therapy were administered followed by postoperative adjuvant chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Esophageal Neoplasms / drug therapy
  • [MeSH-minor] Aged. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Lymphatic Metastasis. Neoadjuvant Therapy. Neoplasm Staging. Taxoids / administration & dosage

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  • (PMID = 20150639.001).
  • [ISSN] 1791-7530
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Taxoids; 15H5577CQD / docetaxel; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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6. Tobari S, Ikeda Y, Kurihara H, Takami H, Okinaga K, Kodaira S: Effective treatment with chemotherapy and surgery for advanced small cell carcinoma of the esophagus. Hepatogastroenterology; 2004 Jul-Aug;51(58):1027-9
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  • [Title] Effective treatment with chemotherapy and surgery for advanced small cell carcinoma of the esophagus.
  • An abdominal computed tomography scan showed massive ascites, extensive paracardial mass, a large mass which invaded the pancreas, and a mass of multiple para-aortic lymphadenopathies which involved the superior mesenteric artery.
  • An upper gastrointestinal endoscopic study revealed an infiltrative, ulcerating tumor of the lower esophagus.
  • Histological study of the biopsy specimens from esophageal tumor showed small cell carcinoma.
  • After combination chemotherapy, an abdominal computed tomography scan showed a disappearance of asites, a partial response reduction of paragastric mass, peripancreatic mass and para-aortic lymphadenopathies.
  • Histological study of the biopsy specimens from esophageal tumor showed a viable small cell carcinoma.
  • In June 2001, the patient underwent lower esophagectomy and proximal gastrectomy combined with splenectomy and distal pancreatectomy through an abdominal approach.
  • Histological findings of the resected specimen showed that the esophageal tumor was a small cell carcinoma which invaded into the submucosal layer, and both paracardial and peripancreatic tumors, and all lymph nodes had no cancer cells.
  • The patient's postoperative recovery was uneventful and discharged without aggressive chemotherapy postoperatively.
  • However, he eventually died of progression of the metastasis 21 months after first detection of the carcinoma.
  • Patients with esophageal small cell carcinoma treated with surgery following chemotherapy and/or radiotherapy have been reported to survive longer than those treated with chemotherapy and/or radiotherapy.
  • Therefore, surgical resection may be recommended as the second therapy that occasionally produces long-term remission and possibly long-term survival for patients with small cell carcinoma of the esophagus.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / surgery. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / surgery. Esophagectomy
  • [MeSH-minor] Aged. Antineoplastic Agents / administration & dosage. Antineoplastic Agents, Phytogenic / administration & dosage. Cisplatin / administration & dosage. Combined Modality Therapy. Etoposide / administration & dosage. Humans. Male. Neoplasm Invasiveness. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 15239239.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Phytogenic; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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7. Heroor A, Fujita H, Sueyoshi S, Tanaka T, Toh U, Mine T, Sasahara H, Sudo T, Matono S, Yamana H, Shirouzu K: Adjuvant chemotherapy after radical resection of squamous cell carcinoma in the thoracic esophagus: who benefits? A retrospective study. Dig Surg; 2003;20(3):229-35; discussion 236-7
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  • [Title] Adjuvant chemotherapy after radical resection of squamous cell carcinoma in the thoracic esophagus: who benefits? A retrospective study.
  • BACKGROUND: A definitive combined modality therapy superior to surgery alone has not yet been found for esophageal cancer.
  • This retrospective study investigated the impact of postoperative adjuvant chemotherapy in patients who underwent curative (R0) esophagectomy with radical lymphadenectomy.
  • STUDY DESIGN: Two hundred and eleven patients with a squamous cell carcinoma in the thoracic esophagus who underwent transthoracic curative (R0) esophagectomy with radical lymphadenectomy, such as 3-field lymphadenectomy or total 2-field lymphadenectomy, between 1988 and 2000, were retrospectively reviewed.
  • Ninety-four patients received postoperative chemotherapy - 2 courses of cisplatin (CDDP) plus fluorouracil (5-FU) or vindesine (VDS) - while the other 117 patients received surgery alone.
  • RESULTS: Only in the subgroup of patients with 8 or more lymph nodes metastasis- positive, the surgery-with-postoperative-chemotherapy group had a significantly better survival than the surgery-alone group.
  • CONCLUSIONS: Postoperative adjuvant chemotherapy following curative (R0) esophagectomy with radical lymphadenectomy such as 3-field lymphadenectomy or total 2-field lymphadenectomy provided a benefit only in patients having metastasis in a large number - 8 or more - lymph nodes.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Esophageal Neoplasms / drug therapy. Esophagectomy
  • [MeSH-minor] Chemotherapy, Adjuvant. Cisplatin. Combined Modality Therapy. Drug Administration Schedule. Female. Fluorouracil. Humans. Lymph Node Excision. Male. Middle Aged. Prognosis. Retrospective Studies. Survival Rate

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  • [Copyright] Copyright 2003 S. Karger AG, Basel
  • (PMID = 12759503.001).
  • [ISSN] 0253-4886
  • [Journal-full-title] Digestive surgery
  • [ISO-abbreviation] Dig Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; CF regimen
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8. Cescon DW, Bradbury PA, Asomaning K, Hopkins J, Zhai R, Zhou W, Wang Z, Kulke M, Su L, Ma C, Xu W, Marshall AL, Heist RS, Wain JC, Lynch TJ Jr, Christiani DC, Liu G: p53 Arg72Pro and MDM2 T309G polymorphisms, histology, and esophageal cancer prognosis. Clin Cancer Res; 2009 May 1;15(9):3103-9
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  • EXPERIMENTAL DESIGN: A cohort of 371 patients with esophageal carcinoma enrolled in Boston, USA from 1999 to 2004 were genotyped for the p53 and MDM2 SNPs.
  • Cox proportional hazard models, adjusted for age, stage, performance status, and smoking were developed.
  • Interaction analyses were done for histology (adenocarcinoma versus squamous cell carcinoma).
  • MDM2 G/G was associated with markedly reduced survival in squamous cell carcinoma (MS of 10.3 versus 49.4 months; adjusted hazard ratio for death, 7.9; 95% confidence interval, 2.4-26.0; P = 0.0007 for G/G versus T/T) but not in adenocarcinoma (SNP-histology interaction P = 0.004).
  • CONCLUSIONS: In a large prospective cohort, p53 Arg72Pro Pro/Pro was associated with a 2-fold increased risk of death in all esophageal cancers, whereas MDM2 T309G G/G was associated with a 7-fold increased risk of death in squamous cell carcinoma.

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  • (PMID = 19383811.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / CA093401-05; United States / NCI NIH HHS / CA / CA093401-01A2; United States / NCI NIH HHS / CA / K23 CA093401-01A2; United States / NCI NIH HHS / CA / K23 CA093401-04; United States / NCI NIH HHS / CA / CA093401-03; United States / NCI NIH HHS / CA / R01 CA074386; United States / NCI NIH HHS / CA / K23 CA093401-02; United States / NCI NIH HHS / CA / CA093401-02; United States / NCI NIH HHS / CA / CA093401-04; United States / NCI NIH HHS / CA / K23 CA093401; United States / NCI NIH HHS / CA / K23 CA093401-03; United States / NCI NIH HHS / CA / R01 CA074386-11; United States / NCI NIH HHS / CA / K23 CA093401-05
  • [Publication-type] Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / TP53 protein, human; 0 / Tumor Suppressor Protein p53; 94ZLA3W45F / Arginine; 9DLQ4CIU6V / Proline; EC 6.3.2.19 / MDM2 protein, human; EC 6.3.2.19 / Proto-Oncogene Proteins c-mdm2
  • [Other-IDs] NLM/ NIHMS284949; NLM/ PMC3081782
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9. Reboul FL: Radiotherapy and chemotherapy in locally advanced non-small cell lung cancer: preclinical and early clinical data. Hematol Oncol Clin North Am; 2004 Feb;18(1):41-53
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  • [Title] Radiotherapy and chemotherapy in locally advanced non-small cell lung cancer: preclinical and early clinical data.
  • Over the past 20 years, combined treatment with radiotherapy and second-generation chemotherapy drugs was extensively studied in patients with locally advanced NSCLC and became the standard over radiotherapy alone in patients with good performance status.
  • Close temporal administration of cisplatin and radiation is mandatory for enhanced antitumor efficacy, but results in significant toxicity to normal tissues.
  • Further improvement in survival also requires an effective treatment of micro-metastatic disease through full-dose delivery of cytotoxic drugs and the addition of at least one more active drug in conjunction with cisplatin and radiotherapy to further improve locoregional control of the disease.
  • In most clinical studies, etoposide was the second drug of choice because of its own radiosensitizing properties and possible synergy with cisplatin.
  • In phase III studies, these results were shown to be superior to radiotherapy alone and to induction chemotherapy followed by STD-RT.
  • At this time, there is no firm evidence that concurrent chemotherapy with HFX-RT is superior to concurrent chemotherapy with STD-RT in terms of local control and survival.
  • Studies on postinduction surgery after concurrent chemoradiotherapy have been of major interest, demonstrating that a complete pathologic response rate of 25% to 30% could be achieved with a relatively low dose of radiation (45 Gy) and that downstaging was a major determinant for improved long-term survival.
  • Long-term survival after trimodality treatment, however, does not appear to be significantly different from what can be achieved with concurrent chemoradiotherapy alone in phase II studies.
  • Whether postinduction surgery is beneficial to patients with histologically proved stage III (N2) and stage IIIB patients was the question addressed in a large, recently completed phase III intergroup trial and of which the results are eagerly awaited.
  • Over the past 10 years, further progress in radiation technology has been accomplished through three-dimensional treatment planning, multileaf collimators, and electronic portal imaging devices, leading to high-precision conformal radiotherapy and dose escalation and (it is hoped) to improved local control.
  • Accurate delineation of critical organs and pretreatment analysis of toxicity-predicting factors allow for better protection of normal intrathoracic tissues such as lung and esophagus and, it is hoped, will lead to a significant reduction in the incidence of radiation esophagitis and pneumonitis.
  • Third-generation drugs such as taxanes, vinorelbine, and gemcitabine have demonstrated high response rates in NSCLC patients with favorable toxicity profiles.
  • These drugs have also shown major radiosensitizing properties in the laboratory and in the clinical setting, often leading, however, to excessive radiosensitization and unacceptable normal tissue toxicities when administered at full dose concurrently with radiotherapy.
  • Weekly administration of these drugs at reduced doses during a full course of conformational radiotherapy up to 70 Gy or more, however, resulted in encouraging results in several phase II studies, with median survival in excess of 20 months and 2- and 3-year survival rates near 50% and 40%, respectively.
  • The respective benefits of either induction or consolidation full-dose chemotherapy with these drugs, before or after concurrent chemoradiotherapy with second- or third-generation chemotherapy, are presently being evaluated in phase III studies.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / drug therapy. Carcinoma, Non-Small-Cell Lung / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Animals. Antineoplastic Agents / therapeutic use. Clinical Trials as Topic. Combined Modality Therapy. Cranial Irradiation. Drug Evaluation, Preclinical. Humans

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  • (PMID = 15005280.001).
  • [ISSN] 0889-8588
  • [Journal-full-title] Hematology/oncology clinics of North America
  • [ISO-abbreviation] Hematol. Oncol. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 44
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10. Pantvaidya GH, Pramesh CS, Deshpande MS, Jambhekar NA, Sharma S, Deshpande RK: Small cell carcinoma of the esophagus: the Tata Memorial Hospital experience. Ann Thorac Surg; 2002 Dec;74(6):1924-7
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  • [Title] Small cell carcinoma of the esophagus: the Tata Memorial Hospital experience.
  • BACKGROUND: Small cell carcinoma of the esophagus is a rare disease, characterized by aggressive progression.
  • Treatment protocols are not well established because of the paucity of cases and a lack of large studies.
  • METHODS: We performed a retrospective review of all patients with small cell carcinoma of the esophagus diagnosed at the Tata Memorial Hospital between 1985 and 2001.
  • We retrieved and analyzed data regarding demographic details, diagnosis, staging, type of treatment, and overall survival.
  • RESULTS: Eighteen patients with a mean age of 62 years (range 48 to 80 years) diagnosed as having small cell carcinoma of the esophagus were analyzed.
  • Four patients were treated with surgery, with or without chemotherapy or radiotherapy.
  • Three patients were treated with combination chemoradiotherapy, 2 patients with chemotherapy alone, and 5 patients with radiotherapy alone.
  • Four patients with advanced disease and poor general condition were not offered any treatment.
  • Patients treated with surgery and chemotherapy had a better overall survival.
  • CONCLUSIONS: Small cell carcinoma of the esophagus should be regarded as a systemic disease with a high distant failure rate.
  • Treatment strategies hence must incorporate systemic chemotherapy along with radical surgery or radiotherapy as part of a multimodality approach.
  • [MeSH-major] Carcinoma, Small Cell / therapy. Esophageal Neoplasms / therapy
  • [MeSH-minor] Aged. Aged, 80 and over. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Staging. Retrospective Studies

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  • (PMID = 12643374.001).
  • [ISSN] 0003-4975
  • [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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11. 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).
  • Twenty-one patients (70%) completed the planned treatment.
  • The median survival time was 21 months.
  • [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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12. Burmeister BH, Dickie G, Smithers BM, Hodge R, Morton K: Thirty-four patients with carcinoma of the cervical esophagus treated with chemoradiation therapy. Arch Otolaryngol Head Neck Surg; 2000 Feb;126(2):205-8
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  • [Title] Thirty-four patients with carcinoma of the cervical esophagus treated with chemoradiation therapy.
  • OBJECTIVE: To review the experience of 2 institutions in the management of localized carcinoma of the cervical esophagus with chemoradiation therapy.
  • DESIGN: A series of 34 patients received chemoradiation therapy for a 5-year period.
  • Three different regimens were used, all involving concomitant chemotherapy and high-dose radiation therapy.
  • PATIENTS: Patients with biopsy-proved carcinoma of the cervical esophagus.
  • INTERVENTIONS: Patients received 3 different chemotherapy regimens.
  • The high-dose cisplatin regimen was a large dose of cisplatin (80 mg/m2) given on days 1 and 22 followed by a 96-hour infusion of fluorouracil (800 mg/m2) from days 2 to 5 and from days 23 to 26.
  • The mean radiation dose administered was 61.2 Gy in 29.6 fractions during 41.8 days using 4- or 6-mV photons and a shrinking field technique.
  • RESULTS: The results of treatment have shown a high rate of local control, although some patients developed metastases.
  • The local complete response rate following treatment was 91%, and the rate of local control of disease was 88%.
  • The acute toxic effects of the treatment were acceptable, with only 5 patients requiring nasogastric feeding or gavage.
  • CONCLUSION: Concomitant chemoradiation therapy, should be the treatment of choice for carcinoma of the cervical esophagus.
  • [MeSH-major] Adenocarcinoma / drug therapy. Adenocarcinoma / radiotherapy. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Radiotherapy Dosage. Radiotherapy, High-Energy. Retrospective Studies. Survival Rate

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  • (PMID = 10680872.001).
  • [ISSN] 0886-4470
  • [Journal-full-title] Archives of otolaryngology--head & neck surgery
  • [ISO-abbreviation] Arch. Otolaryngol. Head Neck Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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13. Mesenas S, Vu C, McStay M, Forshaw M, Doig L, Mason R, Boyle N, Meenan J: A large series, resection controlled study to assess the value of radial EUS in restaging gastroesophageal cancer following neoadjuvant chemotherapy. Dis Esophagus; 2008;21(1):37-42
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  • [Title] A large series, resection controlled study to assess the value of radial EUS in restaging gastroesophageal cancer following neoadjuvant chemotherapy.
  • The true value of endoscopic ultrasound (EUS) post-neoadjuvant chemotherapy for esophageal carcinoma is not established.
  • Superior loco-regional detail may yield useful staging and prognostic information but information on its accuracy, as compared with computed tomography (CT), remains undefined and limited by small study size.
  • All had EUS and helical CT imaging before and after neoadjuvant chemotherapy and the results were compared with pathological staging of resected specimens.
  • There was no difference in T and N stage accuracies between EUS and CT following neoadjuvant chemotherapy. manova showed a reduction in maximal tumor depth by > 50% at EUS to be associated with longer survival (relative risk = 0.48, P < 0.05).
  • This large series study demonstrates the staging accuracy of CT and non-biopsy EUS in the setting of neoadjuvant chemotherapy for gastroesophageal cancer to be equivalent and poor.

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  • (PMID = 18197937.001).
  • [ISSN] 1442-2050
  • [Journal-full-title] Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
  • [ISO-abbreviation] Dis. Esophagus
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] United States
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14. Igaki H, Kato H, Tachimori Y, Sato H, Daiko H, Nakanishi Y: Prognostic evaluation for squamous cell carcinomas of the lower thoracic esophagus treated with three-field lymph node dissection. Eur J Cardiothorac Surg; 2001 Jun;19(6):887-93
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  • [Title] Prognostic evaluation for squamous cell carcinomas of the lower thoracic esophagus treated with three-field lymph node dissection.
  • OBJECTIVE: The efficacy of esophagectomy with three-field lymph node dissection in surgical treatment for patients with squamous cell carcinomas of the lower thoracic esophagus remains controversial.
  • This report documents the outcomes of this surgical procedure for a large series.
  • METHODS: From February 1986 to November 1998, 437 patients with squamous cell carcinomas of the thoracic esophagus underwent transthoracic esophagectomy with three-field lymph node dissection.
  • One hundred and sixteen of these had cancer of the lower thoracic esophagus.
  • To avoid the influence of adjuvant therapy on survival, 20 who also received radiation and/or chemotherapy were excluded, leaving 96 patients who were retrospectively analyzed.
  • CONCLUSIONS: Patients with pathologic T3 tumors with both pathologic N1 status and the presence of intramural metastasis in the lower thoracic esophagus had a poor prognosis.
  • Cervical or celiac lymph node metastasis in patients with carcinomas of the lower thoracic esophagus should be distinguished from pathologic M1 status in the UICC-TNM staging system.
  • [MeSH-major] Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / surgery. Lymph Node Excision / methods

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  • (PMID = 11404147.001).
  • [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] England
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15. 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.
  • 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 purpose of this analysis, institutions were stratified as either large or small based on the number of new cases seen each year.
  • A review of the histology revealed a nearly 50:50 split between squamous cell and adenocarcinoma.
  • Patients treated at large centers were more likely to undergo EUS than those treated at small centers (23% vs. 12%, p = 0.047).
  • 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).
  • [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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16. Tagami K, Tanda S, Tokumura H, Yamaguchi M: [A case of triple malignant tumors consisting of esophagus, stomach and malignant lymphoma with a histopathological feature of collision between gastric cancer and malignant lymphoma--a case report]. Gan To Kagaku Ryoho; 2010 Dec;37(13):2891-5
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  • [Title] [A case of triple malignant tumors consisting of esophagus, stomach and malignant lymphoma with a histopathological feature of collision between gastric cancer and malignant lymphoma--a case report].
  • We report a rare case of a collision between a gastric cancer and a malignant lymphoma with a wide systemic metastasis, combined with esophagus cancer, stomach cancer and malignant lymphoma.
  • He was diagnosed with malignant diffuse large B cell lymphoma by immunostaining from the extirpated right testis.
  • He received six cycles of R-CHOP therapy.
  • Thereafter, we performed MTX-HOPE therapy as a salvage therapy for four cycles.
  • During this chemotherapy, he felt epigastralgia; esophagus cancer (squamous cell carcinoma) and stomach cancer (highly-differentiated adenocarcinoma) were found by upper endoscopy.
  • [MeSH-major] Adenocarcinoma / pathology. Carcinoma, Squamous Cell / pathology. Esophageal Neoplasms / pathology. Lymphoma, Large B-Cell, Diffuse / pathology. Neoplasms, Multiple Primary / pathology. Stomach Neoplasms / pathology

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  • (PMID = 21160264.001).
  • [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
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17. Stepinac T, Grosjean P, Woodtli A, Monnier P, van den Bergh H, Wagnières G: Optimization of the diameter of a radial irradiation device for photodynamic therapy in the esophagus. Endoscopy; 2002 May;34(5):411-5
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  • [Title] Optimization of the diameter of a radial irradiation device for photodynamic therapy in the esophagus.
  • BACKGROUND AND STUDY AIMS: Photodynamic therapy (PDT) is a local therapeutic technique based on the photosensitization of lesions using a dye prior to light-induced tissue destruction.
  • PDT of intraepithelial neoplasia in Barrett's esophagus, or of early squamous-cell carcinoma of the esophagus, requires light application devices that allow homogeneous and well-defined illumination of the tissue surface.
  • Such devices must be large enough to induce complete unfolding of the esophagus in spite of esophageal motility and elasticity.
  • Flexible transparent hollow tubes with diameters ranging from 13 to 19 mm were successively introduced into the esophagus, and the esophageal wall was viewed from the inside through the tube using a flexible small-diameter endoscope.
  • Observations of the upper, middle, and lower thirds of the esophagus were recorded.
  • RESULTS: No significant difference in the number of folds between the lower and middle parts of the esophagus was noticed.
  • CONCLUSIONS: It appears that 18 mm or more is the optimal diameter for a fixed-geometry cylindrical photodynamic therapy irradiating device for the patient category considered in this study.
  • It was also observed that most folds were located on the side walls of the esophagus.
  • [MeSH-major] Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / pathology. Esophagus / pathology. Lighting / instrumentation. Photochemotherapy / instrumentation

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  • (PMID = 11972275.001).
  • [ISSN] 0013-726X
  • [Journal-full-title] Endoscopy
  • [ISO-abbreviation] Endoscopy
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Coloring Agents; 15XUH0X66N / Tolonium Chloride
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18. Nemoto K, Zhao HJ, Goto T, Ogawa Y, Takai Y, Matsushita H, Takeda K, Takahashi C, Saito H, Yamada S: Radiation therapy for limited-stage small-cell esophageal cancer. Am J Clin Oncol; 2002 Aug;25(4):404-7
MedlinePlus Health Information. consumer health - Esophageal Cancer.

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  • [Title] Radiation therapy for limited-stage small-cell esophageal cancer.
  • Between 1985 and 1999, 20 patients with limited-stage small-cell carcinoma of the esophagus (SCEC) received radiation therapy at Tohoku University Hospital and Miyagi Cancer Center Hospital.
  • Twelve patients received definitive radiation therapy and eight patients received postoperative prophylactic irradiation after surgery.
  • Survival rates differed significantly between the 6 patients who were not treated with chemotherapy (median survival time, 5 months) and the 14 patients who were (24 months) (p = 0.0061).
  • Good local control rates can be obtained by definite or postoperative radiation therapy for SCEC.
  • However, SCEC should be regarded as a systemic disease, and chemotherapy should be given.
  • Multiinstitutional studies are needed to obtain sufficiently large populations for investigation and optimization of local therapy for this disease.
  • [MeSH-major] Carcinoma, Small Cell / radiotherapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Retrospective Studies. Survival Rate

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  • (PMID = 12151974.001).
  • [ISSN] 0277-3732
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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19. Makino T, Hirao M, Fujitani K, Takeda M, Mano M, Tsujinaka T: Sustained complete response following combined nedaplatin+ adriamycin+5-fluorouracil therapy in a patient with superficial esophageal cancer -case report-. Gan To Kagaku Ryoho; 2009 Jul;36(7):1151-4
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  • [Title] Sustained complete response following combined nedaplatin+ adriamycin+5-fluorouracil therapy in a patient with superficial esophageal cancer -case report-.
  • Endoscopic examination revealed a wide 0- II c 2/3- circumferential growth with negative iodine staining in the middle-third of the esophagus (25 approximately 32 cm from the incisors).
  • Biopsy examination revealed moderately differentiated squamous cell carcinoma of the esophagus.
  • The depth of invasion was suspected to be not beyond the mucosa (m2), and computed tomography and ultrasonography revealed neither lymph node nor distant metastasis.
  • Esophagectomy or chemoradiation (CRT) was indicated according to the Japanese guidelines for the treatment of esophageal cancer, because endoscopic mucosal resection (EMR) would have been difficult due to the large width of the lesion (2/3 circumferential growth).
  • Chemotherapy was administered with the combined regimen of nedaplatin+adriamycin+5-fluorouracil (NAF) because the patient desired strongly.
  • At present, 3 years after the chemotherapy, the patient remains free of any evidence of recurrence.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Esophageal Neoplasms / drug therapy
  • [MeSH-minor] Antibiotics, Antineoplastic / administration & dosage. Antimetabolites, Antineoplastic / administration & dosage. Antineoplastic Agents / administration & dosage. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / pathology. Doxorubicin / administration & dosage. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Organoplatinum Compounds / administration & dosage. Treatment Outcome

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  • (PMID = 19620806.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents; 0 / Organoplatinum Compounds; 80168379AG / Doxorubicin; 8UQ3W6JXAN / nedaplatin; U3P01618RT / Fluorouracil
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20. Hillinger S, Weder W: Extended surgical resection in stage III non-small cell lung cancer. Front Radiat Ther Oncol; 2010;42:115-21
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  • [Title] Extended surgical resection in stage III non-small cell lung cancer.
  • Stage III includes a large variety of clinical situations from chest wall invasion together with intralobar lymph node metastasis to any size of a lung cancer in combination with mediastinal lymph node involvement (N2/N3).
  • Not surprising the optimal treatment including the role of surgery for stage IIIA (N2) and stage IIIB (T4/N3) non-small cell lung cancer is discussed controversially.
  • Adequate analysis of the clinical stage is key to select the best treatment.
  • A multidisciplinary approach is indicated in most patients, which present with stage III disease at diagnosis.
  • Adjuvant chemotherapy is recommended and radiotherapy is reserved for cases with unclear resection margins.
  • If unforeseen N2 disease is found during surgery, an adjuvant therapy is recommended.
  • Patients with T4 tumors (infiltration of great vessels, trachea, esophagus, vertebral bodies, etc.) show an increasing 5-year survival from 15 to 35% after radical resection with acceptable perioperative mortality if treated in experienced centers.
  • In stage III non-small cell lung cancer, surgery should be performed within a multimodality approach.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / pathology. Carcinoma, Non-Small-Cell Lung / surgery. Lung Neoplasms / pathology. Lung Neoplasms / surgery
  • [MeSH-minor] Chemotherapy, Adjuvant. Clinical Trials as Topic. Combined Modality Therapy. Humans. Lymphatic Metastasis. Neoplasm Staging. Pneumonectomy. Prognosis. Survival Rate. Treatment Outcome

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  • [Copyright] Copyright 2010 S. Karger AG, Basel.
  • (PMID = 19955797.001).
  • [ISSN] 0071-9676
  • [Journal-full-title] Frontiers of radiation therapy and oncology
  • [ISO-abbreviation] Front Radiat Ther Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Number-of-references] 22
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21. Tanaka K, Yano M, Motoori M, Kishi K, Miyashiro I, Shingai T, Gotoh K, Noura S, Takahashi H, Ohue M, Yamada T, Ohigashi H, Yamamoto T, Yamasaki T, Doki Y, Ishikawa O: CEA-antigen and SCC-antigen mRNA expression in peripheral blood predict hematogenous recurrence after resection in patients with esophageal cancer. Ann Surg Oncol; 2010 Oct;17(10):2779-86
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  • BACKGROUND: Although several studies have suggested an association between circulating tumor cells (CTC) and prognosis after esophageal cancer surgery, large-scale studies are lacking.
  • The aim of this study was to prospectively examine the correlation between CTC and outcome in a large number of patients who underwent esophagectomy.
  • MATERIALS AND METHODS: A cohort of 244 patients with squamous cell carcinoma of the esophagus who underwent curative surgery between 2002 and 2007 were prospectively analyzed for CTC before surgery and after the thoracic procedure.
  • RESULTS: CTC was positive in 34 patients (13.9%) before surgery and in 41 patients (16.8%) after the thoracic procedure.
  • Multivariate analysis identified tumor depth (hazard ratio [HR], 0.439; 95% confidence interval [95% CI], 0.268-0.722; P = 0.0012), lymph node metastasis (HR, 2.467; 95% CI, 1.436-4.237; P = 0.0011), venous invasion (HR, 1.802; 95% CI, 1.082-3.002; P = 0.0236), and CTC status after the thoracic procedure (HR, 1.647; 95% CI, 1.032-2.629; P = 0.0365) as independent prognostic factors of disease-free survival.
  • The rates of hematogenous (P = 0.0222) and local (P = 0.0464) recurrences were significantly higher in patients with CTC(+) after the thoracic procedure than those with CTC(-) after the thoracic procedure.
  • Responders to neoadjuvant chemotherapy showed less lymphatic invasion and a decreased positive CTC rate after the thoracic procedure than nonresponders.
  • CONCLUSIONS: CTC status after the thoracic procedure is a useful predictor for hematogenous and local recurrences in patients with esophageal cancer.
  • [MeSH-minor] Carcinoma, Squamous Cell / genetics. Carcinoma, Squamous Cell / metabolism. Carcinoma, Squamous Cell / surgery. Cohort Studies. Female. Follow-Up Studies. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Invasiveness. Neoplastic Cells, Circulating / pathology. Pancreatic Neoplasms / genetics. Pancreatic Neoplasms / metabolism. Pancreatic Neoplasms / surgery. Prognosis. Prospective Studies. RNA, Neoplasm / genetics. Reverse Transcriptase Polymerase Chain Reaction. Survival Rate

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  • (PMID = 20411433.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / Biomarkers, Tumor; 0 / Carcinoembryonic Antigen; 0 / RNA, Messenger; 0 / RNA, Neoplasm; 0 / Serpins; 0 / squamous cell carcinoma-related antigen
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22. Gomi K, Oguchi M, Hirokawa Y, Kenjo M, Ogata T, Takahashi Y, Nakamura N, Yamashita T, Teshima T, Inoue T, Japanese Patterns of Care Study Working Subgroup of Esophageal Cancer: Process and preliminary outcome of a patterns-of-care study of esophageal cancer in Japan: patients treated with surgery and radiotherapy. Int J Radiat Oncol Biol Phys; 2003 Jul 1;56(3):813-22
MedlinePlus Health Information. consumer health - Esophageal Cancer.

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  • We present the preliminary results of surgery combined with RT with or without chemotherapy for thoracic esophageal cancer.
  • Pathologically, 218 patients (99.5%) had squamous cell carcinoma, predominantly located in the middle and lower thoracic esophagus, 41.7% of the patients had Stage III disease; they accounted for 52.6% of patients in nonacademic institutions and for 37.7% of those in academic institutions (p = 0.016).
  • Sixty-nine patients received preoperative RT; of them, 60.9% received chemotherapy; 145 patients received postoperative RT with or without chemotherapy.
  • The spinal cord of 23 (11.7%) of 196 patients was irradiated with >/=50 Gy.
  • In academic institutions, extended radical "three-field" lymphatic dissection was performed for 72 (48.7%) of 148 patients; however, this sophisticated surgical procedure was done in only 13 (25.5%) of 51 patients in nonacademic settings (p = 0.004).
  • In all large academic institutions (those treating >/=300 patients annually), >/=6 MV of photon energy was used; 30.5% of nonacademic institutes had linear accelerators of <6 MV photon (p = 0.001).
  • No deviations occurred in the radiation dose (median 46 Gy), fractionations, or fields between the two types of institutions.
  • Multivariate analysis showed that the type of institution (p = 0.045, risk ratio = 0.604), stage (p 0.029, risk ratio = 0.572), no residual tumor (p = 0.006, risk ratio = 0.487), photon energy (p = 0.043, risk ratio = 0.579), and use of chemotherapy (p = 0.012, risk ratio = 1.907) significantly affected overall survival.
  • CONCLUSION: This PCS showed that in Japan important issues are present regarding RT for esophageal cancer that should be solved immediately, namely, treatment strategy, photon energy, and dose applied to the spinal cord.
  • [MeSH-major] Carcinoma, Squamous Cell / radiotherapy. Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / radiotherapy. Esophageal Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Analysis of Variance. Combined Modality Therapy. Female. Humans. Japan. Karnofsky Performance Status. Male. Middle Aged. Neoplasm Staging. Radiotherapy Dosage. United States

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  • (PMID = 12788190.001).
  • [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] Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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23. Morgan MA, Twine CP, Lewis WG, Lambe R, Oliphant HE, Robinson M, Crosby TD, Roberts SA: Prognostic significance of failure to cross esophageal tumors by endoluminal ultrasound. Dis Esophagus; 2008;21(6):508-13
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  • The aim of this study was to audit the above in a large consecutive case series of Endoscopic Ultrasound (EUS) examinations for esophageal cancer performed in a regional specialist cancer network with particular reference to outcome.
  • Failure to traverse the primary tumor was associated with a diagnosis of squamous cell cancer (8 of 12 patients, 66%, rho = -0.182, P = 0.011).
  • Limited staging information was obtained in 7 of these patients, which altered the computed tomography stage in 5 patients (71%, 3 upstaged, 2 downstaged).
  • Six patients received definitive chemoradiotherapy, two patients surgery and four patients palliative chemotherapy.

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  • (PMID = 18430190.001).
  • [ISSN] 1442-2050
  • [Journal-full-title] Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
  • [ISO-abbreviation] Dis. Esophagus
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] United States
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24. Kobayashi O, Murakami H, Yoshida T, Cho H, Yoshikawa T, Tsuburaya A, Sairenji M, Motohashi H, Sugiyama Y, Kameda Y: Clinical diagnosis of metastatic gastric tumors: clinicopathologic findings and prognosis of nine patients in a single cancer center. World J Surg; 2004 Jun;28(6):548-51
MedlinePlus Health Information. consumer health - Stomach Cancer.

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  • [Title] Clinical diagnosis of metastatic gastric tumors: clinicopathologic findings and prognosis of nine patients in a single cancer center.
  • The primary tumors included one each of squamous cell carcinoma of the esophagus, signet-ring cell carcinoma of the breast, large-cell or small-cell carcinoma of the lung, renal cell carcinoma, hepatocellular carcinoma, squamous cell or epidermoid carcinoma of the uterus, and melanoma.
  • Five patients were treated by chemotherapy with no apparent survival benefit.
  • A median survival after MGT diagnosis was 170 days (range 16-892 days) for all cases, 384 days for those who underwent gastrectomy (n = 6), and 27 days for those without active treatment (n = 3) (p = 0.002).
  • [MeSH-major] Stomach Neoplasms / diagnosis. Stomach Neoplasms / mortality

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  • (PMID = 15366743.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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25. Nettesheim O, Höffken G, Gahr M, Breidert M: [Haematemesis and dysphagia in a 20-year-old woman with congenital spine malformation and situs inversus partialis]. Z Gastroenterol; 2003 Apr;41(4):319-24
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  • [Transliterated title] Hämatemesis und Dysphagie bei 20 Jahre alter Frau mit kongenitalem kaudalen Regressionssyndrom und Situs inversus partialis.
  • Upper endoscopy demonstrated a 4 cm large, exophytically growing necrotic tumour of the oesophagus.
  • Histology of the tumour biopsies showed a poor differentiated squamous cell carcinoma.
  • Staging after the 6 th dose cisplatin (100 mg/m2/die) and 5-fluorouracil (5 x 1000 mg/m2/die) showed a mild reduction of the tumour and the metastases.
  • The manifestation of squamous cell carcinoma of the oesophagus is unusual in people at the age of twenty.
  • Drug history revealed that the patient had been treated with the alpha-receptor blocking drug phenoxybenzamine over at least 12 years for bladder dysfunction.
  • By the German admission board phenoxybenzamine is only recommended for short term therapy.
  • It seems to be likely that even in humans phenoxybenzamine acts as a mutagenic substance and should be carefully used in long-term treatment.
  • [MeSH-major] Carcinoma, Squamous Cell / secondary. Deglutition Disorders / etiology. Esophageal Neoplasms / diagnosis. Hematemesis / etiology. Kyphosis / congenital. Lung Neoplasms / secondary. Neural Tube Defects / diagnosis. Scoliosis / congenital. Situs Inversus / diagnosis. Spina Bifida Occulta / diagnosis
  • [MeSH-minor] Adrenergic alpha-Antagonists / adverse effects. Adrenergic alpha-Antagonists / therapeutic use. Adult. Biopsy. Esophagus / pathology. Female. Humans. Long-Term Care. Neoplasm Staging. Phenoxybenzamine / administration & dosage. Phenoxybenzamine / adverse effects. Urinary Bladder, Neurogenic / congenital. Urinary Bladder, Neurogenic / drug therapy


26. Meluch AA, Greco FA, Gray JR, Thomas M, Sutton VM, Davis JL, Kalman LA, Shaffer DW, Yost K, Rinaldi DA, Hainsworth JD: Preoperative therapy with concurrent paclitaxel/carboplatin/infusional 5-FU and radiation therapy in locoregional esophageal cancer: final results of a Minnie Pearl Cancer Research Network phase II trial. Cancer J; 2003 Jul-Aug;9(4):251-60
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  • [Title] Preoperative therapy with concurrent paclitaxel/carboplatin/infusional 5-FU and radiation therapy in locoregional esophageal cancer: final results of a Minnie Pearl Cancer Research Network phase II trial.
  • PURPOSE: This phase II study was designed to determine the feasibility, toxicity, and therapeutic efficacy of a novel outpatient combined-modality preoperative regimen in patients with localized esophageal cancer.
  • PATIENTS AND METHODS: One hundred twenty-nine eligible patients with previously untreated, potentially resectable, clinical stage I-III carcinoma of the esophagus were treated between July 1995 and July 1999.
  • Combined-modality treatment included: paclitaxel, 200 mg/m2, 1-hour i.v. infusion, days 1 and 22; carboplatin, an area under the concentration time curve 6.0 i.v., days 1 and 22; 5-fluorouracil, 225 mg/m2/day, continuous i.v. infusion, days 1-42; and radiation therapy, 45 Gy, 1.8-Gy single daily fractions 5 days weekly, beginning day 1.
  • All patients underwent surgical resection 4-8 weeks after completion of the preoperative therapy.
  • RESULTS: One hundred twenty-three patients (95%) completed preoperative therapy, 105 patients (81%) underwent attempted resection, and 96 patients (74%) had definitive resection.
  • Although 73 patients (57%) required brief hospitalizations during preoperative therapy, there were no treatment-related deaths, and 94% of patients remained candidates for resection after the completion of treatment.
  • CONCLUSIONS: This novel combined-modality regimen is highly active in the treatment of locoregional esophageal cancer, producing an actuarial 3-year survival of 41%.
  • Although this preoperative regimen produced moderate acute toxicity, there were no treatment-related deaths and the large majority of patients were able to undergo subsequent esophageal resection.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy. Esophagectomy. Neoadjuvant Therapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / radiotherapy. Adult. Aged. Aged, 80 and over. Area Under Curve. Carboplatin / administration & dosage. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Chemotherapy, Adjuvant / adverse effects. Drug Administration Schedule. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Paclitaxel / administration & dosage. Radiotherapy, Adjuvant / adverse effects. Survival Analysis. Treatment Outcome

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  • [CommentIn] Cancer J. 2003 Jul-Aug;9(4):238-40 [12967131.001]
  • (PMID = 12967135.001).
  • [ISSN] 1528-9117
  • [Journal-full-title] Cancer journal (Sudbury, Mass.)
  • [ISO-abbreviation] Cancer J
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel; U3P01618RT / Fluorouracil
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27. 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.

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  • 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.
  • A few patients are identified early in the disease because of screening for gastroesophageal reflux and Barrett's esophagus.
  • 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.
  • In light of these results, additional large randomized phase III studies are needed to confirm the potential benefit of preoperative concurrent chemoradiotherapy.
  • 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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