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1. Panter SJ, O'Flanagan H, Bramble MG, Hungin AP: Empirical use of antisecretory drug therapy delays diagnosis of upper gastrointestinal adenocarcinoma but does not effect outcome. Aliment Pharmacol Ther; 2004 May 1;19(9):981-8
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  • [Title] Empirical use of antisecretory drug therapy delays diagnosis of upper gastrointestinal adenocarcinoma but does not effect outcome.
  • Although the incidence of gastric adenocarcinoma is falling, oesophageal adenocarcinoma is increasing.
  • This has been attributed to an increasing prevalence of gastro-oesophageal reflux disease, commonly treated empirically in primary care with antisecretory drugs.
  • Treatment has been associated with delayed diagnosis but it is unclear if this influences prognosis.
  • AIMS: To ascertain the effect of antisecretory drugs on time to diagnosis, symptoms, tumour stage and outcome.
  • METHODS: A retrospective cohort study of primary care records for 747 patients diagnosed with upper gastrointestinal adenocarcinoma at South Tees NHS Trust between 1991 and 2001.
  • RESULTS: Mean time from the onset of symptoms to diagnosis was 30 weeks.
  • Mean and median times at the primary care stage were longer than at the hospital stage for both oesophageal and gastric cancer (P < 0.0001).
  • Patients with benign symptoms prescribed antisecretory drugs were referred later than those not on antisecretory drugs (P < 0.0001), as were patients with alarm symptoms (P = 0.0008).
  • Prior use of antisecretory drugs delayed diagnosis by 17.6 weeks (mean) but had no effect on tumour stage at diagnosis or survival.
  • CONCLUSION: Prior antisecretory drug therapy was associated with delayed diagnosis of upper gastrointestinal adenocarcinoma irrespective of presenting symptoms.
  • Concerns that delays might adversely affect tumour stage or long-term survival were not substantiated.
  • [MeSH-major] Adenocarcinoma / drug therapy. Esophageal Neoplasms / drug therapy. Gastrointestinal Agents / therapeutic use. Stomach Neoplasms / drug therapy

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  • (PMID = 15113364.001).
  • [ISSN] 0269-2813
  • [Journal-full-title] Alimentary pharmacology & therapeutics
  • [ISO-abbreviation] Aliment. Pharmacol. Ther.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Gastrointestinal Agents
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2. Starling N, Okines A, Cunningham D, Allum W, Wotherspoon A, Benson M, Thompson J, Thomas J, Brown G, Riddell A, Stavridi F, Ashley S, Oates J, Chau I: A phase II trial of preoperative chemotherapy with epirubicin, cisplatin and capecitabine for patients with localised gastro-oesophageal junctional adenocarcinoma. Br J Cancer; 2009 Jun 2;100(11):1725-30
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  • [Title] A phase II trial of preoperative chemotherapy with epirubicin, cisplatin and capecitabine for patients with localised gastro-oesophageal junctional adenocarcinoma.
  • Preoperative cisplatin/fluorouracil is used for the treatment of localised oesophageal carcinoma.
  • Patients with stage II or III oesophageal/gastro-oesophageal junctional adenocarcinoma from one institution received 4 cycles of ECX (epirubicin 50 mg m(-2) day 1, cisplatin 60 mg m(-2) day 1, capecitabine 625 mg m(-2) b.i.d. daily) followed by surgery.
  • The primary end point was the pathological complete response (pCR) rate based on a Simon two-stage design.
  • Thirteen out of 28 (46%) evaluable patients responded to chemotherapy by EUS (>or=30% reduction in maximal tumour thickness).
  • However, with a median follow-up of 34 months the median OS and 1- and 2-year survival rates were 17 months, 67 and 39% respectively.
  • Although associated with a low pCR rate, survival with ECX was comparable with published studies suggesting that pCR may not correlate with satisfactory outcome from preoperative chemotherapy for localised oesophageal adenocarcinoma.
  • [MeSH-major] Adenocarcinoma / drug therapy. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / therapeutic use. Deoxycytidine / analogs & derivatives. Epirubicin / therapeutic use. Esophageal Neoplasms / drug therapy. Fluorouracil / analogs & derivatives. Stomach Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Capecitabine. Combined Modality Therapy. Disease Progression. Female. Follow-Up Studies. Humans. Male. Middle Aged. Survival Rate

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  • (PMID = 19436301.001).
  • [ISSN] 1532-1827
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; 3Z8479ZZ5X / Epirubicin; 6804DJ8Z9U / Capecitabine; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
  • [Other-IDs] NLM/ PMC2695693
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3. Blanchard P, Quero L, Hennequin C: [Prognostic and predictive factors of oesophageal carcinoma]. Bull Cancer; 2009 Apr;96(4):379-89
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  • [Title] [Prognostic and predictive factors of oesophageal carcinoma].
  • [Transliterated title] Facteurs pronostiques et prédictifs des cancers de l'oesophage.
  • Oesophageal carcinoma is a frequent disease, which incidence is high and stable (6,000 new cases per year in France).
  • Its epidemiology has changed over the last three decades, adenocarcinoma becoming the most frequent histologic subtype.
  • The prognosis of oesophageal carcinoma remains poor despite improved diagnosis and therapeutic strategies.
  • The aim of this review is to describe the major prognostic and predictive factors of oesophageal carcinoma.
  • These factors are mostly based on patient characteristics (performance status, weight loss, hemoglobin level), tumor spread (TNM stage, lymph node micrometastases, ratio of involved lymph nodes, extracapsular involvement), radicality of surgical resection (R0) or radiological and endoscopic response to chemoradiation therapy.
  • An early decrease of tumoral glucose uptake measured by PET-CT appears to be a predictive factor of response to antitumor treatment.
  • Genetic profiles of drug action pathways in oesophageal carcinoma have been described.
  • They may provide additional information to predict tumor response to medical treatment.
  • [MeSH-major] Adenocarcinoma. Carcinoma, Squamous Cell. Esophageal Neoplasms
  • [MeSH-minor] Biomarkers, Tumor / blood. Hemoglobin A / analysis. Humans. Karnofsky Performance Status. Lymphatic Metastasis / pathology. Prognosis. Treatment Outcome. Tumor Burden. Weight Loss

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  • (PMID = 19357013.001).
  • [ISSN] 1769-6917
  • [Journal-full-title] Bulletin du cancer
  • [ISO-abbreviation] Bull Cancer
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 9034-51-9 / Hemoglobin A
  • [Number-of-references] 82
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4. Geh JI, Glynne-Jones R, Kwok QS, Banerji U, Livingstone JI, Townsend ER, Harrison RA, Mitchell IC: Preoperative ECF chemotherapy in gastro-oesophageal adenocarcinoma. Clin Oncol (R Coll Radiol); 2000;12(3):182-7
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  • [Title] Preoperative ECF chemotherapy in gastro-oesophageal adenocarcinoma.
  • Epirubicin, cisplatin and continuous 5-fluorouracil (5-FU) infusion (ECF) has been reported to result in high clinical response rates in advanced gastro-oesophageal adenocarcinoma and is currently the 'gold standard' chemotherapy regimen for this tumour site.
  • Despite this, its role as preoperative (neoadjuvant) treatment is unproven and therefore remains under investigation.
  • We report our experience using ECF (intravenous epirubicin 50 mg/m2 and cisplatin 60 mg/m2 every 3 weeks, with continuous infusion of 5-FU 200 mg/m2 per day) as preoperative treatment in locally advanced adenocarcinoma of the lower oesophagus, gastro-oesophageal junction and stomach.
  • Clinical disease progression occurred in six patients (26%) during chemotherapy.
  • Two patients had Stage II (T2N(0-1)) disease and nine were Stage III (T(3-4)N(0-1)).
  • Therefore, despite good symptomatic response rates, ECF chemotherapy given in the preoperative setting did not appear to improve the outcome of patients with unresectable or radiologically lymph node-positive gastro-oesophageal adenocarcinoma.
  • The role of ECF chemotherapy in resectable tumours is unclear and is currently under investigation in the randomized MRC Adjuvant Gastric Infusional Chemotherapy (MAGIC) study.
  • [MeSH-major] Adenocarcinoma / drug therapy. Adenocarcinoma / surgery. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / surgery. Stomach Neoplasms / drug therapy. Stomach Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Cisplatin / adverse effects. Epirubicin / administration & dosage. Epirubicin / adverse effects. Female. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Humans. Male. Middle Aged. Neoadjuvant Therapy. Survival Rate

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  • (PMID = 10942336.001).
  • [ISSN] 0936-6555
  • [Journal-full-title] Clinical oncology (Royal College of Radiologists (Great Britain))
  • [ISO-abbreviation] Clin Oncol (R Coll Radiol)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 3Z8479ZZ5X / Epirubicin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; FPEPIR regimen
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5. Fareed KR, Ilyas M, Kaye PV, Soomro IN, Lobo DN, Parsons SL, Madhusudan S: Tumour regression grade (TRG) analyses in patients with resectable gastro-oesophageal adenocarcinomas treated with platinum-based neoadjuvant chemotherapy. Histopathology; 2009 Oct;55(4):399-406
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  • [Title] Tumour regression grade (TRG) analyses in patients with resectable gastro-oesophageal adenocarcinomas treated with platinum-based neoadjuvant chemotherapy.
  • AIMS: Neoadjuvant chemotherapy followed by surgery is the standard of care for patients with gastro-oesophageal adenocarcinoma.
  • The aims were to validate the utility of the tumour regression grade (TRG) in patients who have received chemotherapy and to investigate if (i) TRG correlates with tumour downstaging and (ii) TRG could provide a comparative platform for future predictive biomarker investigations.
  • METHODS AND RESULTS: Three pathologists were blinded to the treatment approaches.
  • Review included diagnosis, tumour grade, TNM staging, vascular invasion, perineural invasion, resection margin involvement and histopathological response to chemotherapy, as measured by TRG.
  • In the neoadjuvant chemotherapy (CS) group (n = 84), 46.7% of gastric/gastro-oesophageal junction adenocarcinomas, and 45.5% of lower third oesophageal adenocarcinomas had TRG 1, 2 or 3 compared with 13.7% in the primary surgery group (n = 124) (P < 0.001 and P = 0.006, respectively).
  • In the CS group, responders (TRG 1, 2 or 3) showed significant tumour downstaging [early ypT-stage disease (P = 0.002)].
  • CONCLUSIONS: TRG may reflect response to chemotherapy.
  • [MeSH-major] Adenocarcinoma / drug therapy. Adenocarcinoma / surgery. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / surgery. Neoadjuvant Therapy / methods. Platinum / therapeutic use. Stomach Neoplasms / drug therapy. Stomach Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Capecitabine. Cisplatin / administration & dosage. Combined Modality Therapy. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Dose-Response Relationship, Drug. Epirubicin / administration & dosage. Female. Fluorouracil / administration & dosage. Fluorouracil / analogs & derivatives. Humans. Male. Middle Aged. Neoplasm Staging. Remission Induction. Retrospective Studies. Single-Blind Method. Treatment Outcome

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  • (PMID = 19817890.001).
  • [ISSN] 1365-2559
  • [Journal-full-title] Histopathology
  • [ISO-abbreviation] Histopathology
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; 3Z8479ZZ5X / Epirubicin; 49DFR088MY / Platinum; 6804DJ8Z9U / Capecitabine; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; FPEPIR regimen
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6. Valentí V, Fares S, Reynolds N, Cohen P, Theodoro N, Martínez-Isla A: [Open and laparoscopic transhiatal oesophagectomy for cancer of the oesophagus: analysis of resection margins and lymph nodes]. Cir Esp; 2008 Jan;83(1):24-7
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  • [Transliterated title] Esofagectomía transhiatal por vía abierta y vía laparoscópica para el cáncer de esófago: análisis de los márgenes de resección y ganglios linfáticos.
  • INTRODUCTION: Surgical treatment of cancer of the oesophagus is associated with a high morbidity and mortality.
  • Minimally invasive surgery has been proposed as an alternative to try to reduce these complications; however, at this time there are not many studies that evaluate the oncological validity of this method.
  • MATERIAL AND METHOD: Between April 2003 and February 2007, 40 patients diagnosed with distal oesophageal cancer were surgically intervened at Charing Cross Hospital, London, 24 open and 16 by laparoscopy in accordance with the surgeon responsible.
  • Of these, 50% received neoadjuvant chemotherapy.
  • Both groups were homogeneous for age, sex, ASA, tumour stage and tumour location.
  • In all cases, the pathological tumour stage (TNM), the tumour distal margin, tumour proximal margin, tumour circumference and number of resected lymph nodes, were collected in a data base.
  • The mean distal tumour margin for the group treated by open surgery was 4.9 cm compared to 4.3 in the group treated by laparoscopy (p = 0.578).
  • [MeSH-major] Adenocarcinoma / surgery. Esophageal Neoplasms / surgery. Esophagectomy / methods. Laparoscopy. Lymph Node Excision
  • [MeSH-minor] Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Data Interpretation, Statistical. Esophagus / pathology. Female. Humans. Male. Middle Aged. Minimally Invasive Surgical Procedures. Neoplasm Staging. Treatment Outcome

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  • [ErratumIn] Cir Esp. 2008 Dec;84(6):295. Fares, Rally [corrected to Fares, Sally]
  • (PMID = 18208745.001).
  • [ISSN] 0009-739X
  • [Journal-full-title] Cirugía española
  • [ISO-abbreviation] Cir Esp
  • [Language] spa
  • [Publication-type] Comparative Study; English Abstract; Evaluation Studies; Journal Article
  • [Publication-country] Spain
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7. Anderson SE, Minsky BD, Bains M, Hummer A, Kelsen D, Ilson DH: Combined modality chemoradiation in elderly oesophageal cancer patients. Br J Cancer; 2007 Jun 18;96(12):1823-7
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  • [Title] Combined modality chemoradiation in elderly oesophageal cancer patients.
  • We present a single institution experience with 5-FU, mitomycin-C based chemoradiation for the primary treatment of elderly patients with oesophageal cancer.
  • Twenty-five patients with a median age of 77 years (range 66-88) with a diagnosis of stage II-III squamous cell or adenocarcinoma of the oesophagus were treated at Memorial Sloan Kettering from 1996 to 2001 with two cycles of concurrent 5-FU, mitomycin-C and 50.4 Gy.
  • Of the 23 patients evaluable for response, 17 patients (68%) had a negative post-treatment endoscopy and CT scan without evidence of progressive disease.
  • Eleven patients (44%) are alive and 10 (40%) remain without evidence of recurrent or progressive oesophageal cancer at a median follow-up of 35 months.
  • There was no significant difference in overall survival between Charlson score </=2 and those with a score >/=2 (P=0.10).
  • Similar survival was observed for patients with adenocarcinoma or squamous carcinoma.
  • Primary chemoradiation with two cycles of 5-FU, mitomycin-C, and 50.4 Gy in elderly patients is an active regimen with moderate toxicity, despite the advanced age and heavy comorbidity burden of this cohort.
  • Patients with local/regional oesophageal cancer with adequate functional status should not be excluded from potentially curative treatment based on age alone.
  • [MeSH-major] Adenocarcinoma / drug therapy. Adenocarcinoma / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Fluorouracil / administration & dosage. Humans. Mitomycin / administration & dosage. Survival Analysis

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  • (PMID = 17533399.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
  • [Other-IDs] NLM/ PMC2359964
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8. van Vliet EP, Eijkemans MJ, Steyerberg EW, Kuipers EJ, Tilanus HW, van der Gaast A, Siersema PD: The role of socio-economic status in the decision making on diagnosis and treatment of oesophageal cancer in The Netherlands. Br J Cancer; 2006 Nov 6;95(9):1180-5
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  • [Title] The role of socio-economic status in the decision making on diagnosis and treatment of oesophageal cancer in The Netherlands.
  • In the United States (USA), a correlation has been demonstrated between socio-economic status (SES) of patients on the one hand, and tumour histology, stage of the disease and treatment modality of various cancer types on the other hand.
  • It is unknown whether such correlations are also involved in patients with oesophageal cancer in The Netherlands.
  • Between 1994 and 2003, 888 oesophageal cancer patients were included in a prospective database with findings on the diagnostic work-up and treatment of oesophageal cancer.
  • Linear-by-linear association testing revealed that oesophageal adenocarcinoma was more frequently observed in patients with higher SES and squamous cell carcinoma in patients with lower SES (P=0.02).
  • Multivariable logistic regression analysis showed no correlation between SES and staging procedures and preoperative TNM stage.
  • Patients with a higher SES more frequently underwent resection or were treated with chemotherapy (OR: 1.15; 95% CI 1.01-1.32 and OR: 1.16; 95% CI 1.02-1.32, respectively).
  • Socio-economic factors are involved in oesophageal cancer in The Netherlands, as patients with a higher SES are more likely to have an adenocarcinoma and patients with a lower SES a squamous cell carcinoma.
  • Moreover, the correlations between SES and different treatment modalities suggest that both patient and doctor determinants contribute to the decision on the most optimal treatment modality in patients with oesophageal cancer.
  • [MeSH-major] Esophageal Neoplasms / diagnosis. Esophageal Neoplasms / therapy. Social Class
  • [MeSH-minor] Adenocarcinoma / diagnosis. Adenocarcinoma / therapy. Aged. Carcinoma, Squamous Cell / diagnosis. Carcinoma, Squamous Cell / therapy. Databases as Topic / statistics & numerical data. Female. Humans. Logistic Models. Male. Middle Aged. Multivariate Analysis. Neoplasm Staging. Netherlands. Prospective Studies

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  • (PMID = 17031405.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2360583
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9. Safranek PM, Sujendran V, Baron R, Warner N, Blesing C, Maynard ND: Oxford experience with neoadjuvant chemotherapy and surgical resection for esophageal adenocarcinomas and squamous cell tumors. Dis Esophagus; 2008;21(3):201-6
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  • [Title] Oxford experience with neoadjuvant chemotherapy and surgical resection for esophageal adenocarcinomas and squamous cell tumors.
  • The Medical Research Council trial for oesophageal cancer (OEO2) trial demonstrated a clear survival benefit from neoadjuvant chemotherapy in resectable esophageal carcinoma.
  • Since February 2000 it has been our practice to offer this chemotherapy regime to patients with T2 and T3 or T1N1 tumors.
  • We analyzed prospectively collected data of patients who received neoadjuvant chemotherapy prior to esophageal resection under the care of a single surgeon.
  • Complications of treatment and overall outcomes were evaluated.
  • A total of 194 patients had cisplatin and 5-fluorouracil prior to esophageal resection.
  • During chemotherapy one patient died and one perforated (operated immediately).
  • Complications including severe neutropenia, coronary artery spasm, renal impairment and pulmonary edema led to the premature cessation of chemotherapy in 12 patients (6.2%).
  • A total of 182 patients with a median age of 63 (range 30-80), 41 squamous and 141 adenocarcinomas underwent surgery.
  • Operations were 91 left thoracoabdominal (50%), 45 radical transhiatal (25%), 40 Ivor-Lewis (22%) and six stage three (3%), and 78.6% had microscopically complete (R0) resections.
  • A radical surgical approach to the primary tumor in combination with OEO2 neoadjuvant chemotherapy has led to a high R0 resection rate and good survival with acceptable morbidity and mortality.

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  • (PMID = 18430099.001).
  • [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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10. Ott K, Lordick F, Herrmann K, Krause BJ, Schuhmacher C, Siewert JR: The new credo: induction chemotherapy in locally advanced gastric cancer: consequences for surgical strategies. Gastric Cancer; 2008;11(1):1-9
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  • [Title] The new credo: induction chemotherapy in locally advanced gastric cancer: consequences for surgical strategies.
  • Perioperative chemotherapy in stage II and stage III gastric cancer is now accepted as a standard of care in the Western world.
  • Two randomized phase III studies have shown improved survival for patients with induction chemotherapy followed by surgery compared with surgery alone.
  • It is generally accepted that patients who respond to induction therapy have a significantly improved survival compared with that in nonresponding patients.
  • In adenocarcinomas of the esophagogastric junction (AEG), fluorodeoxyglucose-positron emission tomography (FDG-PET) prospectively was established as a surrogate predicting response and prognosis.
  • The MUNICON (Metabolic response evalUatioN for Individualisation of neoadjuvant Chemotherapy in oesOphageal and oesophagogastric adeNocarcinoma) I study confirmed prospectively the usefulness of early metabolic response evaluation and showed the feasibility of a PET-guided treatment algorithm.
  • These findings are an important step forward in the tailoring of multimodal treatment in accordance with tumor biology.
  • In gastric cancer, we have analyzed FDG-PET in a prospective study.
  • Insufficient FDG uptake is mostly associated with diffuse-type gastric cancer with signet ring cells and mucinous content.
  • Treatment concepts such as immediate resection after only 2 weeks of induction therapy with or without adjuvant treatment could be considered in metabolic nonresponders, or modified chemotherapy regimens, possibly including biologically targeted drugs, could be considered in those with FDG-nonavid tumors.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Neoadjuvant Therapy / methods. Positron-Emission Tomography. Stomach Neoplasms / drug therapy. Stomach Neoplasms / surgery
  • [MeSH-minor] Contrast Media. Disease Progression. Fluorodeoxyglucose F18. Humans. Neoplasm Staging. Prognosis. Radiopharmaceuticals. Treatment Outcome

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  • (PMID = 18373171.001).
  • [ISSN] 1436-3291
  • [Journal-full-title] Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
  • [ISO-abbreviation] Gastric Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Contrast Media; 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
  • [Number-of-references] 42
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11. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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.
  • 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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12. 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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13. Díaz R, Reynes G, Tormo A, de Juan M, Gironés R, Segura A, Aparicio J, Richart P, de la Cueva H, García J: Long-term results of neoadjuvant chemotherapy and combined chemoradiotherapy before surgery in the management of locally advanced oesophageal cancer: a single-centre experience. Clin Transl Oncol; 2009 Dec;11(12):835-41
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  • [Title] Long-term results of neoadjuvant chemotherapy and combined chemoradiotherapy before surgery in the management of locally advanced oesophageal cancer: a single-centre experience.
  • INTRODUCTION: Neoadjuvant chemoradiotherapy before surgery is an option in the treatment of locally advanced resectable oesophageal cancer (EC).
  • METHODS: This was a prospective, single-centre study of neoadjuvant chemotherapy and concomitant chemoradiotherapy with CDDP and 5-FU and 50.4 Gy of external radiotherapy before possible radical surgery in patients with locally advanced resectable EC.
  • If surgery was not possible, a second-phase radiotherapy boost of 10 Gy and one cycle of modified dose chemotherapy were used.
  • RESULTS: Seventy-three patients included between 1998 and 2007: 96% males, median age 61, 83% squamous cell carcinomas, 23% lower third tumours, 36% stage II and 54% stage III and 47% local lymph node involvement.
  • The achievement of a complete response is a powerful prognostic factor.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy. Esophageal Neoplasms / surgery
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / mortality. Adenocarcinoma / radiotherapy. Adenocarcinoma / surgery. Adult. Aged. Aged, 80 and over. Algorithms. Combined Modality Therapy. Disease Progression. Drug Administration Schedule. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoadjuvant Therapy. Survival Analysis. Time Factors

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  • (PMID = 20045790.001).
  • [ISSN] 1699-3055
  • [Journal-full-title] Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
  • [ISO-abbreviation] Clin Transl Oncol
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Italy
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14. Morgan MA, Lewis WG, Casbard A, Roberts SA, Adams R, Clark GW, Havard TJ, Crosby TD: Stage-for-stage comparison of definitive chemoradiotherapy, surgery alone and neoadjuvant chemotherapy for oesophageal carcinoma. Br J Surg; 2009 Nov;96(11):1300-7
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  • [Title] Stage-for-stage comparison of definitive chemoradiotherapy, surgery alone and neoadjuvant chemotherapy for oesophageal carcinoma.
  • BACKGROUND: Definitive chemoradiotherapy (dCRT) has been proposed as an alternative therapy for selected patients with oesophageal cancer.
  • The aim of this study was to determine the outcomes of dCRT, surgery alone, and neoadjuvant chemotherapy followed by surgery (CS) in patients with oesophageal cancer.
  • METHODS: Consecutive patients diagnosed with oesophageal cancer and managed by a multidisciplinary team were staged by computed tomography and endoluminal ultrasonography.
  • Those deemed unsuitable for surgery on the grounds of performance status, bulky local disease or personal choice received dCRT.
  • CONCLUSION: These findings support the need for a randomized trial of dCRT versus CS for resectable oesophageal cancer.
  • [MeSH-major] Adenocarcinoma / therapy. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / therapy. Esophageal Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant / mortality. Esophagectomy / mortality. Female. Humans. Male. Middle Aged. Neoplasm Staging. Radiotherapy, Adjuvant / mortality. Survival Analysis. Tomography, X-Ray Computed

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  • [CommentIn] Br J Surg. 2010 May;97(5):792-3; author reply 793 [20393986.001]
  • (PMID = 19847875.001).
  • [ISSN] 1365-2168
  • [Journal-full-title] The British journal of surgery
  • [ISO-abbreviation] Br J Surg
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] England
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15. Valle JW, Lawrance J, Brewer J, Clayton A, Corrie P, Alakhov V, Ranson M: A phase II, window study of SP1049C as first-line therapy in inoperable metastatic adenocarcinoma of the oesophagus. J Clin Oncol; 2004 Jul 15;22(14_suppl):4195

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A phase II, window study of SP1049C as first-line therapy in inoperable metastatic adenocarcinoma of the oesophagus.
  • METHODS: Chemotherapy- or radiotherapy-naïve patients with measurable, inoperable or metastatic, biopsy-proven, adenocarcinoma of the oesophagus; KP ≥60; normal cardiac LVEF; adequate swallowing and adequate renal, hepatic and bone marrow function were eligible.
  • TREATMENT: SP1049C 75mg/m2 IV 30-minute infusion was given q3w, for up to 6 cycles.
  • Upon disease progression (PD) patients were offered standard chemotherapy.
  • RESULTS: From February 2002 to date, 17 male patients; median age 62 years (range 49 - 78); 16 with stage IV disease and 1 unknown stage (TxN1M0); were enrolled.
  • Radiological response after 2 cycles: one (10%) PR, 8 (80%) SD (including 4 (40%) with minor responses) and one (10%) PD.
  • One responding patient underwent salvage resection (pT2N0 (Stage 2A) tumour).
  • Non-haematological toxicity (Gd1-2,Gd3-4): nausea (73%,0%), anorexia (45%,9%), lethargy (55%,18%), febrile neutropaenia (0%,36%), weight loss (35%,0%), vomiting (45%,18%), mucositis (55%,9%), and Gd 1-2 alopecia in 55%.
  • CONCLUSIONS: SP1049C appears to be active in advanced oesophageal adenocarcinoma based on the preliminary results of the first 10 patients and the study will continue accrual to a total of 24 evaluable patients.

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  • (PMID = 28013894.001).
  • [ISSN] 1527-7755
  • [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] Journal Article
  • [Publication-country] United States
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16. Cheong KA, Chrystal K, Forshaw M, Gossage J, Galani E, Botha A, Mason R, Harper PG: Neoadjuvant chemotherapy in "technically" inoperable locally advanced oesophageal (O) and gastro-oesophageal junction (GOJ) cancer. J Clin Oncol; 2004 Jul 15;22(14_suppl):4138

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Neoadjuvant chemotherapy in "technically" inoperable locally advanced oesophageal (O) and gastro-oesophageal junction (GOJ) cancer.
  • : 4138 Background: Primary surgery results in a poor outcome for patients with locally advanced O and GOJ tumours who at staging have no distant metastases.
  • For this group we routinely use 3 cycles of neoadjuvant ECF-based chemotherapy (Epirubicin:60mg/m<sup>2</sup>, Cisplatin:60mg/m<sup>2</sup>, 5FU 200mg/m<sup>2</sup> CIVI q21).
  • All patients commencing chemotherapy were included.
  • Chemotherapy variations depended on comorbidities and renal function.
  • HISTOLOGY: adenocarcinoma 80%, squamous cell 20%.
  • Tumour Location: GO junction 76%, oesophageal 24%.
  • Stage at presentation: T3/T4N0 17%, T3/T4N1 58%, and T3/T4N1M1a 25%.
  • Chemotherapy regimen: ECF 73%, ECSF 10%, ECarboF 10%, CF 7%.
  • 85% of patients completed a minimum of 3 cycles of neoadjuvant chemotherapy.
  • The overall radiological response rate was 49% (7%CR and 42%PR) 36% SD and 15% PD.
  • 18 pts had further adjuvant therapy (34% chemo, 7% chemoradiation, 2% radiation).
  • CONCLUSIONS: Surgery following successful neoadjuvant chemotherapy for initially inoperable locally advanced O and GOJ cancer can produce encouraging survival rates.
  • Prospective studies, including identification of prognostic and predictive factors for response to chemotherapy are required.

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  • (PMID = 28014551.001).
  • [ISSN] 1527-7755
  • [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] Journal Article
  • [Publication-country] United States
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17. Tougeron D, Di Fiore F, Hamidou H, Rigal O, Paillot B, Michel P: Response to definitive chemoradiotherapy and survival in patients with an oesophageal adenocarcinoma versus squamous cell carcinoma: a matched-pair analysis. Oncology; 2007;73(5-6):328-34
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Response to definitive chemoradiotherapy and survival in patients with an oesophageal adenocarcinoma versus squamous cell carcinoma: a matched-pair analysis.
  • OBJECTIVES: The impact of the histological tumour type in patients treated with definitive chemoradiotherapy (CRT) for an oesophageal cancer is not well established.
  • The aim of this retrospective matched-pair analysis was to evaluate the clinical complete response (CCR) to definitive CRT and the outcome between 2 groups of patients.
  • METHODS: Fifty-seven patients with an oesophageal adenocarcinoma (ADC) were matched according to the tumour stage and the WHO performance as well as the CRT regimen status including 57 patients with an oesophageal squamous cell carcinoma (SCC).
  • CRT was based on radiotherapy combined with a cisplatin-based chemotherapy.
  • In responders to CRT, local recurrence was significantly more frequent in SCC patients (52.5 vs. 26.9%, p = 0.046).
  • CONCLUSION: Our study showed that treatment completion and CCR to definitive CRT were more frequent in SCC with, however, more local recurrences in these patients.
  • Further studies are required to confirm this difference in response rate to definitive CRT according to histological type of the tumour in oesophageal cancer.
  • [MeSH-major] Adenocarcinoma / drug therapy. Adenocarcinoma / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Deglutition Disorders / epidemiology. Female. France / epidemiology. Humans. Incidence. Male. Middle Aged. Prognosis. Retrospective Studies. Smoking / adverse effects. Smoking / epidemiology. Survival Analysis. Treatment Outcome


18. Okines AF, Cunningham D: Multimodality treatment for localized gastro-oesophageal cancer. Ann Oncol; 2010 Oct;21 Suppl 7:vii286-93
MedlinePlus Health Information. consumer health - Stomach Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Multimodality treatment for localized gastro-oesophageal cancer.
  • Surgery alone remains an international standard of care for early stage (Ia) oesophagogastric cancers.
  • There is also international consensus that multimodality therapy is appropriate for more advanced stage operable disease, however there is marked geographical variation in standard practice.
  • Similarly, perioperative triplet chemotherapy improves survival compared to surgery alone in gastroesophageal adenocarcinomas and is widely used across Europe and Australasia.
  • For oesophageal adenocarcinoma, neo-adjuvant chemotherapy and neo-adjuvant chemoradiation are further accepted standards, widely utilized in the UK and US respectively, with similar survival benefits reported for each strategy.
  • Patients with localized squamous cell carcinomas of the oesophagus benefit from chemoradiation, which may be delivered as a neo-adjuvant or definitive strategy, the latter avoiding surgical morbidity and mortality.
  • Targeted agents are currently under evaluation in localized oesophagogastric cancer, with translational sub-studies attempting to define which patients may benefit from the addition of these high cost drugs.

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  • (PMID = 20943630.001).
  • [ISSN] 1569-8041
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
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19. Kolh P, Honore P, Degauque C, Gielen J, Gerard P, Jacquet N: Early stage results after oesophageal resection for malignancy - colon interposition vs. gastric pull-up. Eur J Cardiothorac Surg; 2000 Sep;18(3):293-300
ORBi (University of Liege). Free full Text at ORBi .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Early stage results after oesophageal resection for malignancy - colon interposition vs. gastric pull-up.
  • METHODS: From January 1990 to December 1998, 130 patients underwent oesophageal resection for malignancy.
  • Indications were squamous cell carcinoma in 69 patients and adenocarcinoma in 61.
  • Preoperatively 30 patients (eight in stage IIB, 18 in stage III, and four in stage IV) received radiochemotherapy.
  • There were 84 subtotal oesophagectomies, with anastomosis in the neck in 44 patients and at the thoracic inlet in 40, and 46 distal oesophageal resections.
  • The incidence of postoperative pulmonary complications was 70% (21/30 patients) in the subgroup who received preoperative radiochemotherapy, as compared to 11% (5/44 patients) in the subgroup of comparable staging, but without preoperative treatment (P<0.001).
  • Our results suggest that preoperative neoadjuvant treatment significantly increases postoperative pulmonary complications.
  • [MeSH-major] Adenocarcinoma / surgery. Carcinoma, Squamous Cell / surgery. Colon / transplantation. Esophageal Neoplasms / surgery. Esophagus / surgery. Stomach / surgery
  • [MeSH-minor] Anastomosis, Surgical / methods. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Esophagectomy. Female. Hospital Mortality. Humans. Male. Middle Aged. Palliative Care. Reoperation. Retrospective Studies. Stomach Neoplasms / drug therapy. Stomach Neoplasms / mortality. Stomach Neoplasms / radiotherapy. Stomach Neoplasms / surgery. Survival Rate. Treatment Outcome

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  • (PMID = 10973538.001).
  • [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] Comparative Study; Journal Article
  • [Publication-country] ENGLAND
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20. Veuillez V, Rougier P, Seitz JF: The multidisciplinary management of gastrointestinal cancer. Multimodal treatment of oesophageal cancer. Best Pract Res Clin Gastroenterol; 2007;21(6):947-63
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The multidisciplinary management of gastrointestinal cancer. Multimodal treatment of oesophageal cancer.
  • Treatment of oesophageal cancer requires a multidisciplinary approach.
  • Single modality treatment, especially surgical excision, is only indicated in small tumours or in patients unable to support multimodal treatment.
  • In Stage I-II adenocarcinoma, multimodal treatment using neoadjuvant therapy is indicated in the absence of contra-indications.
  • The choice between radio-chemotherapy and chemotherapy depends on patients' characteristics and the preferences of the treatment centre.
  • In selected Stage III adenocarcinomas, especially from the lower oesophagus, neoadjuvant chemotherapy (with post-operative chemotherapy when feasible) may induce tumour regression, which may facilitate surgical resection and improve survival rates, as has been demonstrated for cancers of the oesophagogastric junction.
  • [MeSH-major] Adenocarcinoma / therapy. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Esophageal Neoplasms / therapy. Esophagectomy. Patient Selection
  • [MeSH-minor] Chemotherapy, Adjuvant. Disease-Free Survival. Humans. Neoadjuvant Therapy. Neoplasm Metastasis. Neoplasm Staging. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 18070697.001).
  • [ISSN] 1521-6918
  • [Journal-full-title] Best practice & research. Clinical gastroenterology
  • [ISO-abbreviation] Best Pract Res Clin Gastroenterol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 70
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21. Font A, Arellano A, Fernández-Llamazares J, Casas D, Boix J, Cardenal J, Margelí M, Manzano JL, Abad A, Rosell R: Weekly docetaxel with concomitant radiotherapy in patients with inoperable oesophageal cancer. Clin Transl Oncol; 2007 Mar;9(3):177-82
Hazardous Substances Data Bank. DOCETAXEL .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Weekly docetaxel with concomitant radiotherapy in patients with inoperable oesophageal cancer.
  • INTRODUCTION: To evaluate the efficacy and tolerability of weekly docetaxel concurrent with radiotherapy in inoperable oesophageal cancer patients.
  • MATERIAL AND METHODS: Thirty-four oesophageal cancer patients with co-morbid medical conditions, locally advanced tumours (T4) or advanced age (older than 75 years) received docetaxel (20 mg/m2 weekly) plus concurrent radiotherapy (2 Gy daily, to a total dose of 66 Gy).
  • Twenty-two patients (64%) were stage III, 19 of whom had T4 tumours.
  • RESULTS: Twenty-seven patients (79%) completed the planned chemoradiotherapy treatment.
  • There were two treatment-related deaths due to radiation pneumonitis.
  • CONCLUSIONS: Docetaxel plus concurrent radiotherapy is active in poor-prognosis oesophageal cancer patients, with a lower incidence of severe oesophagitis than with cisplatin-based chemoradiotherapy regimens.
  • This schedule can be considered, especially in patients with non-T4 tumours who are not candidates for oesophageal resection.
  • [MeSH-major] Adenocarcinoma / therapy. Antineoplastic Agents, Phytogenic / therapeutic use. Carcinoma, Squamous Cell / therapy. Esophageal Neoplasms / therapy. Radiotherapy, High-Energy. Taxoids / therapeutic use
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Comorbidity. Drug Administration Schedule. Esophagitis / etiology. Female. Hematologic Diseases / etiology. Humans. Kaplan-Meier Estimate. Male. Middle Aged. Prognosis. Radiation Pneumonitis / etiology. Remission Induction. Survival Analysis. Treatment Outcome

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  • (PMID = 17403629.001).
  • [ISSN] 1699-048X
  • [Journal-full-title] Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
  • [ISO-abbreviation] Clin Transl Oncol
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase I; Journal Article
  • [Publication-country] Spain
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / Taxoids; 15H5577CQD / docetaxel
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22. Moghissi K, Dixon K, Stringer M, Thorpe JA: Photofrin PDT for early stage oesophageal cancer: long term results in 40 patients and literature review. Photodiagnosis Photodyn Ther; 2009 Sep-Dec;6(3-4):159-66
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Photofrin PDT for early stage oesophageal cancer: long term results in 40 patients and literature review.
  • BACKGROUND: Yorkshire Laser Centre experience of PDT in early oesophageal cancer (EOCa) to determine long survival at 3 and 5 years (absolute) and factors which might influence outcome.
  • MATERIAL/METHOD: The records of patients who had PDT (1997-2009) for oesophageal cancer were reviewed and those with EOCa were studied and analysed.
  • Results were assessed based on pathological response to treatment and survival at 3 and 5 years post-PDT.
  • RESULTS: There were 40 patients with EOCa amongst 144 who had PDT for oesophageal cancer.
  • 35 had adenocarcinoma and 5 squamous cell carcinoma.
  • CONCLUSION: Endoscopic PDT should be considered as the treatment of choice in patients with EOCa who are ineligible for surgical resection.
  • We suggest that a carefully designed study of a cohort of patients with EOCa comparing surgical resection with endoscopic PDT is warranted.
  • [MeSH-major] Dihematoporphyrin Ether / therapeutic use. Endoscopy. Esophageal Neoplasms / drug therapy. Photosensitizing Agents / therapeutic use
  • [MeSH-minor] Aged. Early Detection of Cancer. Female. Follow-Up Studies. Humans. Male. Middle Aged

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  • [CommentIn] Photodiagnosis Photodyn Ther. 2009 Sep-Dec;6(3-4):155-6 [19932445.001]
  • (PMID = 19932447.001).
  • [ISSN] 1873-1597
  • [Journal-full-title] Photodiagnosis and photodynamic therapy
  • [ISO-abbreviation] Photodiagnosis Photodyn Ther
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Photosensitizing Agents; 97067-70-4 / Dihematoporphyrin Ether
  • [Number-of-references] 51
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23. Davies L, Lewis WG, Arnold DT, Escofet X, Blackshaw G, Gwynne S, Evans M, Roberts SA, Appadurai I, Crosby TD: Prognostic significance of age in the radical treatment of oesophageal cancer with surgery or chemoradiotherapy: a prospective observational cohort study. Clin Oncol (R Coll Radiol); 2010 Sep;22(7):578-85
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prognostic significance of age in the radical treatment of oesophageal cancer with surgery or chemoradiotherapy: a prospective observational cohort study.
  • AIMS: To compare the outcomes of stage-directed surgical therapy and chemoradiotherapy (CRT) for oesophageal cancer and to determine if a significant age-treatment interaction exists to guide therapy.
  • MATERIALS AND METHODS: Five hundred and eight consecutive patients with oesophageal cancer suitable for radical treatment based on radiological stage and performance status were studied (275 surgery; 93 surgery alone, 131 neoadjuvant chemotherapy, 51 neoadjuvant CRT and 233 definitive CRT).
  • Multivariate analysis including only surgical patients in the model revealed three factors to be independently and significantly associated with survival; endoscopic ultrasound (EUS) T stage (P=0.033), EUS lymph node metastasis count (>or=2 versus 0: hazard ratio 1.67, 95% confidence interval 1.06-2.92, P=0.026), and age>or=70 years (hazard ratio 1.51, 95% confidence interval 1.05-2.16, P=0.025).
  • CONCLUSION: Overall survival for patients treated with surgery was strongly age dependent around the age of 70 years, and patients>or=70 years with oesophageal cancer should be aware that outcomes after CRT are similar to those after surgery.
  • [MeSH-major] Adenocarcinoma / therapy. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / therapy. Esophageal Neoplasms / therapy. Esophagectomy. Radiotherapy Dosage
  • [MeSH-minor] Adult. Age Factors. Aged. Aged, 80 and over. Cisplatin / administration & dosage. Cohort Studies. Combined Modality Therapy. Epirubicin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neoadjuvant Therapy. Prospective Studies. Survival Rate. Treatment Outcome

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  • [Copyright] Copyright (c) 2010 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
  • (PMID = 20591633.001).
  • [ISSN] 1433-2981
  • [Journal-full-title] Clinical oncology (Royal College of Radiologists (Great Britain))
  • [ISO-abbreviation] Clin Oncol (R Coll Radiol)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 3Z8479ZZ5X / Epirubicin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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24. Servagi-Vernat S, Bosset M, Crehange G, Buffet-Miny J, Puyraveau M, Maingon P, Mercier M, Bosset JF: Feasibility of chemoradiotherapy for oesophageal cancer in elderly patients aged &gt;or=75 years: a prospective, single-arm phase II study. Drugs Aging; 2009;26(3):255-62
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  • [Title] Feasibility of chemoradiotherapy for oesophageal cancer in elderly patients aged >or=75 years: a prospective, single-arm phase II study.
  • BACKGROUND: The number of elderly patients with oesophageal cancer is expected to increase with the aging of the population and the rapidly increasing incidence of adenocarcinoma.
  • Surgical resection is standard treatment for patients with localized disease considered fit for operation.
  • However, elderly patients with oesophageal cancer are rarely referred for surgery.
  • The aim of this prospective, single-arm, phase II study was to evaluate the feasibility and efficacy (tumour response) of chemoradiotherapy in the treatment of elderly patients with localized oesophageal cancer.
  • METHODS: The main study inclusion criteria were: patients aged >or=75 years; oesophageal cancer disease stage II-III; Charlson co-morbidity index score <or=4; Eastern Cooperative Oncology Group (ECOG) performance status 0-2; and weight loss <15%.
  • The radiotherapy regimen consisted of 50 Gy over 5 weeks.
  • The mean age of the patients was 79.4 years (range 75-89 years), 18 were male (81.8%), 15 had squamous cell carcinoma (68%) and 11 had stage IIA disease (50%).
  • All patients were compliant with the planned treatment, including doses and timing.
  • During treatment, ECOG performance status remained stable during the first 3 weeks and worsened slightly over the last 2 weeks.
  • Six weeks after treatment, 14 patients were in complete response (63.6%) and 8 patients (36.4%) had no treatment effect.
  • Four patients (18.2%) were alive without disease from 2.6 to 5.5 years after treatment.
  • In 14 evaluable patients, QOL 6 weeks after treatment was slightly altered by treatment.
  • CONCLUSIONS: The results of this prospective phase II study support the feasibility of chemoradiotherapy for oesophageal cancer in carefully selected elderly patients, with the potential for a curative effect.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Cisplatin / therapeutic use. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / radiotherapy. Aged. Aged, 80 and over. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Combined Modality Therapy. Disease-Free Survival. Female. Follow-Up Studies. Humans. Male. Neoplasm Staging. Prospective Studies. Quality of Life. Survival Rate. Treatment Outcome

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  • (PMID = 19358620.001).
  • [ISSN] 1170-229X
  • [Journal-full-title] Drugs & aging
  • [ISO-abbreviation] Drugs Aging
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] New Zealand
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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25. Moghissi K, Dixon K, Campbell A: Adeno-carcinoma of the pharyngo-oesophageal junction and cervical oesophagus in a patient with an oesophagus lined entirely by columnar epithelium report of a case treated by photodynamic therapy (PDT). Photodiagnosis Photodyn Ther; 2008 Sep;5(3):224-7
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  • [Title] Adeno-carcinoma of the pharyngo-oesophageal junction and cervical oesophagus in a patient with an oesophagus lined entirely by columnar epithelium report of a case treated by photodynamic therapy (PDT).
  • A case of adenocarcinoma in the pharyngo oesophageal junction extending to the upper cervical oesophagus is described.
  • In this case the neo-plastic changes had occurred from columnar epithelium of gastric and intestinal type: Barrett's oesophagus.
  • Because of the general condition of the patient and advanced stage of the tumour surgical treatment was considered inappropriate.
  • Endoscopic Photofrin Photodynamic Therapy was used with good palliation of dysphagia.
  • [MeSH-major] Adenocarcinoma / drug therapy. Esophageal Neoplasms / drug therapy. Gastric Mucosa / pathology. Intestinal Mucosa / pathology. Pharyngeal Neoplasms / drug therapy. Photochemotherapy
  • [MeSH-minor] Aged. Female. Humans. Treatment Outcome

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  • (PMID = 19356659.001).
  • [ISSN] 1873-1597
  • [Journal-full-title] Photodiagnosis and photodynamic therapy
  • [ISO-abbreviation] Photodiagnosis Photodyn Ther
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Netherlands
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26. Black E, Niamat J, Boddu S, Martin-Ucar A, Duffy JP, Morgan WE, Beggs FD: Unplanned splenectomy during oesophagectomy does not affect survival. Eur J Cardiothorac Surg; 2006 Feb;29(2):244-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The aim of this study is to identify the factors associated with a likelihood of inadvertent splenectomy and its influence on early and long-term outcome in patients having oesophagectomy for oesophageal carcinoma.
  • Neoadjuvant chemotherapy was administered to a minority of patients; none subsequently had splenectomy.
  • There were significant differences between types of operation (Ivor-Lewis 18 (9.0%), left thoracolaparotomy 14 (9.9%) and left thoracophrenotomy 15 (3.9%), p=0.01).
  • Splenectomy was more common with advanced N stage disease (OR=0.44 [0.20-0.95]; p=0.04).
  • Type of operation and advanced N stage are important risks for splenectomy.
  • [MeSH-major] Adenocarcinoma / surgery. Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / surgery. Esophagectomy. Splenectomy
  • [MeSH-minor] Aged. Female. Hospital Mortality. Humans. Length of Stay. Male. Middle Aged. Neoplasm Staging. Penicillin V / therapeutic use. Penicillins / therapeutic use. Proportional Hazards Models. Prospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 16388954.001).
  • [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
  • [Chemical-registry-number] 0 / Penicillins; Z61I075U2W / Penicillin V
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27. Cagol M, Ruol A, Sileni VC, De Salvo GL, Corti L, Alfieri R, Innocente R, Fumagalli U, Rosati R, Ancona E: [Multimodal treatment in locally advanced esophageal cancer: a multicenter phase II study with neoadjuvant oxaliplatin, 5-fluorouracil, leucovorin and neoadjuvant radiotherapy: preliminary results]. Chir Ital; 2006 Jul-Aug;58(4):433-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Multimodal treatment in locally advanced esophageal cancer: a multicenter phase II study with neoadjuvant oxaliplatin, 5-fluorouracil, leucovorin and neoadjuvant radiotherapy: preliminary results].
  • The aim of the study was to evaluate the feasibility and efficacy of treatment with oxaliplatin, 5-fluorouracil and leucovorin concomitant with radiation therapy in locally advanced oesophageal cancer.
  • Fifty-eight patients with previously untreated, histologically proven oesophageal cancer were enrolled.
  • The diagnosis was squamous cell carcinoma/adenocarcinoma/poorly differentiated: 45/8/1; clinical stage: T3N1M0 38 (70%), T4 10 (19%), M1a 6 (11%).
  • Thirty-nine patients (72%) received the planned 8 weeks of chemotherapy and 45 completed the entire course of scheduled radiotherapy.
  • Four (7%) toxic deaths were recorded, 2 more patients died prematurely from massive oesophageal bleeding and 1 from progression of disease.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma / drug therapy. Carcinoma / radiotherapy. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy. Neoadjuvant Therapy
  • [MeSH-minor] Adult. Aged. Feasibility Studies. Female. Fluorouracil / administration & dosage. Humans. Leucovorin / administration & dosage. Male. Middle Aged. Neoplasm Staging. Organoplatinum Compounds / administration & dosage. Treatment Outcome

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  • (PMID = 16999147.001).
  • [ISSN] 0009-4773
  • [Journal-full-title] Chirurgia italiana
  • [ISO-abbreviation] Chir Ital
  • [Language] ita
  • [Publication-type] Clinical Trial, Phase II; English Abstract; Journal Article; Multicenter Study
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Organoplatinum Compounds; 04ZR38536J / oxaliplatin; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil
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28. Porfimer: new drug. Endobrachyesophagus: encouraging preliminary results. Prescrire Int; 2006 Apr;15(82):58-9
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  • [Title] Porfimer: new drug. Endobrachyesophagus: encouraging preliminary results.
  • (1) Patients with endobrachyesophagus (Barrett's oesophagus) and high-grade dysplasia are at high risk of developing adenocarcinoma within 3 to 7 years.
  • Local treatments (photocoagulation and endoscopic mucosectomy) are currently under evaluation. (2) Marketing authorisation has been granted for a photodynamic treatment based on intravenous porfimer injection and laser illumination of the lesion. (3) In a randomised trial comparing porfimer photodynamic therapy plus omeprazole with omeprazole alone, 208 patients were monitored for at least 2 years.
  • Thirteen percent of patients on combination treatment developed adenocarcinoma (stage not specified), compared to 29% of patients treated with omeprazole alone (p = 0.006).
  • Nearly half the patients had symptoms of photosensitization, and 38% had oesophageal contraction requiring at least 1 dilation session. (4) In practice, despite some encouraging results, we do not know if photodynamic therapy based on porfimer reduces the long-term risk of recurrence, invasive carcinoma, or major surgery.
  • Porfimer photodynamic therapy needs to be compared with other endoscopic interventions.
  • [MeSH-major] Barrett Esophagus / drug therapy. Dihematoporphyrin Ether / therapeutic use
  • [MeSH-minor] Clinical Trials as Topic. Disease Progression. Humans. Omeprazole / administration & dosage. Omeprazole / adverse effects. Omeprazole / therapeutic use. Photochemotherapy. Photosensitizing Agents / administration & dosage. Photosensitizing Agents / adverse effects. Photosensitizing Agents / therapeutic use. Treatment Outcome

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  • (PMID = 16604738.001).
  • [ISSN] 1167-7422
  • [Journal-full-title] Prescrire international
  • [ISO-abbreviation] Prescrire Int
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Photosensitizing Agents; 97067-70-4 / Dihematoporphyrin Ether; KG60484QX9 / Omeprazole
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29. Denham JW, Steigler A, Kilmurray J, Wratten C, Burmeister B, Lamb DS, Joseph D, Delaney G, Christie D, Jamieson G, Smithers BM, Ackland S, Walpole E: Relapse patterns after chemo-radiation for carcinoma of the oesophagus. Clin Oncol (R Coll Radiol); 2003 May;15(3):98-108
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  • AIM: The detailed review of patterns of failure in this report was undertaken to identify the continuing obstacles to the successful management of oesophageal cancer, and to establish whether there is a case to compare definitive chemo-radiation (Def-CR) and surgery for patients with squamous cancer in a randomized controlled trial.
  • MATERIALS AND METHODS: First and subsequent sites of failure were reviewed in 274 patients treated with Def-CR using two cycles of cisplatin, infusional fluorouracil and 60 Gy; and 92 patients with limited chemo-radiation (CR), using one cycle and 35 Gy, followed by surgery (CR-Surg).
  • All were treated on prospective non-randomized trials run by the Trans-Tasman Radiation Oncology Group between 1985 and 1999.
  • Failure patterns were analysed using competing risks methodology, and pre-treatment variables predicting survival were identified by proportional hazards modelling.
  • RESULTS: Site, stage, performance status and gender were independently predictive of survival following Def-CR.
  • Local failure was evident in 42.3% of patients, but distant failure in isolation occurred in an additional 18.1%.
  • Lowest rates of local and distant failure at 5 years (29.9% and 26%) occurred in patients with squamous cancer (SCC) located in the upper-third, whose 5-year survival was also the most favourable (49.2%).
  • Survival was least favourable in patients with adenocarcinoma (AC) in the lower two-thirds (18.1%) due to higher rates of local (51.5%) and distant (36.1%) failure.
  • Local failure occurred in 31.5% of patients undergoing CR-Surg but distant failure in isolation was observed in a further 34.7%.
  • Patients with no residual cancer in the resection specimen had the lowest rates of local (0%) and distant (16.7%) failure and the best survival (64.9%).
  • CONCLUSION: The concurrent administration of chemotherapy with radiotherapy seems to have improved loco-regional control and has exposed distant failure as an obstacle to further improvements in outcome.
  • Site, histological subtype, gender and response to chemo-radiation may predict biological differences in oesophageal cancer (OC) that influence outcome.
  • [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. Neoplasm Recurrence, Local
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Infusions, Intravenous. Male. Middle Aged. Prognosis. Randomized Controlled Trials as Topic. Retrospective Studies. Survival Analysis

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  • (PMID = 12801045.001).
  • [ISSN] 0936-6555
  • [Journal-full-title] Clinical oncology (Royal College of Radiologists (Great Britain))
  • [ISO-abbreviation] Clin Oncol (R Coll Radiol)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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