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1. Keresztes RS, Port JL, Pasmantier MW, Korst RJ, Altorki NK: Preoperative chemotherapy for esophageal cancer with paclitaxel and carboplatin: results of a phase II trial. J Thorac Cardiovasc Surg; 2003 Nov;126(5):1603-8
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  • [Title] Preoperative chemotherapy for esophageal cancer with paclitaxel and carboplatin: results of a phase II trial.
  • OBJECTIVE: Paclitaxel has one of the highest response rates when used as a single agent in patients with esophageal cancer.
  • The combination of paclitaxel and carboplatin has been shown to be a well-tolerated and safe regimen in non-small cell lung cancer.
  • The objective of this study was to determine the efficacy of preoperative paclitaxel and carboplatin in patients with carcinoma of the esophagus.
  • PATIENTS AND METHODS: A phase II trial was initiated in January 1999 and concluded in January 2001.
  • Patients with stage I disease and those with visceral metastases were excluded.
  • All underwent preoperative computed tomography scanning and endosonography for staging.
  • RESULTS: Twenty-six (11 epidermoid, 15 adenocarcinoma) patients completed the trial.
  • Preoperative staging showed: stage IIA, 6 patients; stage IIB, 1 patient; and stage III, 19 patients.
  • All patients completed their preoperative chemotherapy.
  • There was no unexpected chemotherapy-related toxicity.
  • CONCLUSION: Paclitaxel-carboplatin combination is a safe and well-tolerated regimen for esophageal cancer with clinical response rates comparable to historical controls.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Carboplatin / administration & dosage. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / mortality. Paclitaxel / administration & dosage
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / mortality. Adenocarcinoma / pathology. Adenocarcinoma / surgery. Adult. Aged. Analysis of Variance. Biopsy, Needle. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / mortality. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / surgery. Chemotherapy, Adjuvant. Confidence Intervals. Dose-Response Relationship, Drug. Esophagectomy / methods. Female. Follow-Up Studies. Humans. Male. Maximum Tolerated Dose. Middle Aged. Neoplasm Staging. Pilot Projects. Preoperative Care / methods. Risk Assessment. Survival Analysis. Treatment Outcome

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  • (PMID = 14666040.001).
  • [ISSN] 0022-5223
  • [Journal-full-title] The Journal of thoracic and cardiovascular surgery
  • [ISO-abbreviation] J. Thorac. Cardiovasc. Surg.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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2. Rohatgi P, Swisher SG, Correa AM, Wu TT, Liao Z, Komaki R, Walsh GL, Vaporciyan AA, Rice DC, Roth JA, Ajani JA: Characterization of pathologic complete response after preoperative chemoradiotherapy in carcinoma of the esophagus and outcome after pathologic complete response. Cancer; 2005 Dec 1;104(11):2365-72
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  • [Title] Characterization of pathologic complete response after preoperative chemoradiotherapy in carcinoma of the esophagus and outcome after pathologic complete response.
  • BACKGROUND: The purpose of the current study was to test the hypothesis that a lower clinical TNM stage is associated with a higher rate of pathologic complete response (pathCR) in patients with esophageal carcinoma receiving preoperative chemoradiotherapy and to determine whether outcome after pathCR is related to clinical stage or treatment.
  • METHODS: Clinical parameters and surgical specimens of patients with esophageal carcinoma undergoing preoperative chemoradiotherapy were analyzed to identify predictors of pathCR.
  • In patients with American Joint Committee on Cancer (AJCC) Stage II carcinoma, the proportion achieving pathCR was significantly larger than that achieving <pathCR (65% vs. 35%; P = 0.03).
  • The proportion of patients who received induction chemotherapy was higher in the pathCR group than in the <pathCR group (54% vs. 46%; P = 0.05).
  • However, neither TNM classification, primary tumor location, histologic type, gender, therapy sequence, or radiation dose (45 grays [Gy] vs. 50.4 Gy) were found to have any influence on OS or DFS.
  • CONCLUSIONS: Patients with clinical AJCC Stage II esophageal carcinoma are more likely to achieve a pathCR after preoperative chemoradiotherapy than are those with Stage III carcinoma.
  • Chemoradiotherapy as primary therapy for patients with Stage I esophageal carcinoma warrants investigation as a means to preserve their esophagus.
  • [MeSH-major] Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / pathology. Adenocarcinoma / radiotherapy. Adult. Aged. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / radiotherapy. Female. Humans. Male. Middle Aged. Neoplasm Staging. Predictive Value of Tests. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 16245310.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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3. Ychou M, Senesse P, Quénet F: [Update on gastroenterology]. Bull Cancer; 2000 Jun;87(6):455-61
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  • [Transliterated title] Actualités en gastroentérologie.
  • In the field of mass detection of colorectal cancer by Hemoccul test, the results of the Burgundy study confirm the two european studies previously published and encourage to extend this training to the whole country.
  • When genetic markers are performed in a population selected according to these type I criteria, HNPCC mutation could be detected in 28% of cases.
  • In adjuvant treatment of stage II colon cancer, two contradictory publications have been reported in the Journal of Clinical Oncology.
  • However, the results of the Impact B2 Group are more consistent and support the fact that chemotherapy cannot be recommended as a standard treatment in state II colon cancer.
  • The actualities in the liver metastases focused on the new local destruction technics that are cryosurgery and radiofrequency.
  • Concerning the chemotherapy of metastatic colorectal cancer, important results have been published in second line therapy showing the superiority of Campto compared to best supportive care or 5FU based chemotherapy both in term of overall survival and quality of life.
  • In first line chemotherapy, the superiority of bi-therapies (LV5FU2 and oxaliplatin or LV5FU2 and irinotecan) has been confirmed compared to LV5FU2 alone.
  • A recent publication showed that patients older than 70 years tolerate chemotherapy for colorectal cancer as well as younger patients with the same efficacy.
  • In esophagus carcinoma, the most important study didn't show any efficacy of neoadjuvant chemotherapy by 5FU-cisplatin in operable adenocarcinoma of squamous carcinoma of esophagus.
  • The final results of dutch's study in node dissection for gastric cancer do not find any benefit in overall survival comparing D2 versus D1 dissection with a substantial increase in morbidity and mortality in the D2 arm, specially when splenopancreatectomy was performed.
  • [MeSH-major] Colorectal Neoplasms, Hereditary Nonpolyposis. Esophageal Neoplasms / drug therapy. Stomach Neoplasms / surgery
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Biopsy, Needle / methods. Combined Modality Therapy. Genetic Testing. Humans. Liver Neoplasms / secondary. Lymphatic Metastasis. Mass Screening / methods. Occult Blood

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  • (PMID = 10903787.001).
  • [ISSN] 0007-4551
  • [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 / Antineoplastic Agents
  • [Number-of-references] 22
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4. Adelstein DJ, Rice TW, Rybicki LA, Saxton JP, Videtic GM, Murthy SC, Mason DP, Rodriguez CP, Ives DI: Mature results from a phase II trial of postoperative concurrent chemoradiotherapy for poor prognosis cancer of the esophagus and gastroesophageal junction. J Thorac Oncol; 2009 Oct;4(10):1264-9
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  • [Title] Mature results from a phase II trial of postoperative concurrent chemoradiotherapy for poor prognosis cancer of the esophagus and gastroesophageal junction.
  • INTRODUCTION: Mature results are presented from a phase II trial of postoperative concurrent chemoradiotherapy in patients with poor-prognosis cancer of the esophagus and gastroesophageal junction after primary surgical resection.
  • METHODS: Resected patients with a pathologic stage of T3, N1, or M1a were eligible for this trial.
  • Concurrent chemoradiotherapy was begun between 6 and 10 weeks after surgery and consisted of radiotherapy (1.8 Gy/d to a planned dose of 50.4-59.4 Gy), concurrent with two cycles of 5-fluorouracil (1000 mg/m/d) and cisplatin (20 mg/m/d), both given as 4-day continuous intravenous infusions during the first and fourth weeks of the radiation.
  • The median age was 59 (range, 33-76) years, and most patients were male (86%), Caucasian (96%), and had undergone a transthoracic esophagogastrectomy (74%) for what proved to be a node positive (86%) adenocarcinoma (86%).
  • With a median follow-up of 47 (range, 36-124) months, the Kaplan-Meier 4-year projected overall survival is 51%, freedom from recurrence 50%, distant metastatic control 56%, and locoregional control 86%.
  • An earlier pathologic stage was the only predictor for a better outcome.
  • CONCLUSIONS: This schedule of postoperative concurrent chemoradiotherapy has acceptable toxicity for patients with poor-prognosis esophageal and gastroesophageal junction cancer after surgery.
  • [MeSH-major] Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy. Esophagogastric Junction / pathology. Stomach Neoplasms / drug therapy. Stomach Neoplasms / radiotherapy
  • [MeSH-minor] Adenocarcinoma / pathology. Adenocarcinoma / therapy. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / therapy. Cisplatin / administration & dosage. Esophagectomy. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neoplasm Staging. Postoperative Period. Prospective Studies. Radiotherapy Dosage. Survival Rate. Treatment Outcome

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  • (PMID = 19668013.001).
  • [ISSN] 1556-1380
  • [Journal-full-title] Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
  • [ISO-abbreviation] J Thorac Oncol
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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5. Adelstein DJ, Rice TW, Rybicki LA, Saxton JP, Videtic GM, Murthy SC, Zuccaro G, Vargo JJ, Dumot JA, Carroll MA: A phase II trial of accelerated multimodality therapy for locoregionally advanced cancer of the esophagus and gastroesophageal junction: the impact of clinical heterogeneity. Am J Clin Oncol; 2007 Apr;30(2):172-80
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  • [Title] A phase II trial of accelerated multimodality therapy for locoregionally advanced cancer of the esophagus and gastroesophageal junction: the impact of clinical heterogeneity.
  • OBJECTIVES: This is a report of mature results from a phase II trial of an accelerated multimodality treatment program for locoregionally advanced cancer of the esophagus and gastroesophageal junction with a focus on the impact of clinical heterogeneity on outcomes.
  • A split course of pre- and postoperative hyperfractionated radiation therapy and concurrent chemotherapy was used in an effort to limit perioperative mortality.
  • METHODS: Eligibility required a diagnosis of esophageal or gastroesophageal junction cancer and an esophageal ultrasound stage of at least T3, N1, or M1A.
  • Patients received a 12-day induction course of radiation (1.5 Gy twice a dose to a dose of 30 Gy) concurrent with 4-day continuous intravenous infusions of cisplatin (20 mg/m2 per day) and 5-fluorouracil (1000 mg/m2 per day) beginning on day 1.
  • RESULTS: From October 1999 through March 2003, 93 patients were enrolled; 96% were white, 86% male, and 83% had adenocarcinoma.
  • With a median follow up of 50 months (range, 34-72 months), the 3-year projected overall survival rate is 27.9%, freedom from recurrence 30.5%, and distant metastatic control 32.4%.
  • Freedom from recurrence and distant control were significantly better in patients with 1) earlier pretreatment clinical stage, 2) earlier postinduction pathologic stage, 3) squamous cell cancer, and 4) a pathologic response.
  • CONCLUSIONS: This accelerated multimodality treatment program is feasible and perioperative mortality proved acceptable.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy. Esophagogastric Junction / pathology
  • [MeSH-minor] Adenocarcinoma. Adult. Aged. Carcinoma, Squamous Cell. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Radiotherapy Dosage. Survival Analysis. Survival Rate

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  • (PMID = 17414467.001).
  • [ISSN] 1537-453X
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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6. Stepanov EA, Razumovskiĭ AIu, Bataev S-, Alkhasov AB, Nurik VI, Mart'ianov AV, Bogaeva II: [Treatment policy for children with gastroesophageal reflux complicated by Barrett esophagus]. Khirurgiia (Mosk); 2002;(11):8-13
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  • [Title] [Treatment policy for children with gastroesophageal reflux complicated by Barrett esophagus].
  • Barret's esophagus (BE) is a rare disease in children.
  • Twenty-four-hour pH-metry and manometry of the esophagus, scintigraphy and contrast roentgenoscopy of the esophagus were used for diagnosis of GER.
  • All the children underwent biopsy of mucosa membrane of distal esophagus.
  • Metaplasia of esophageal epithelium by intestinal type (IT) in combination with one by gastric type (GT) were revealed in 8 children, metaplasia by gastric type alone (epithelium of gastric and fundal parts of the stomach)--in 8 children.
  • Six children with IT metaplasia of the esophagus with long strictures underwent extirpation of the esophagus with one-stage esophagoplasty.
  • It esophageal stenosis is not long or is absent, fundoplication by Nissen (4 children) and drug therapy (6 children) are performed.
  • It is concluded that in IT metaplasia of the esophagus with long peptic esophageal strictures resistant to bouginage extirpation of the esophagus with one-stage coloesophagoplasty is desirable.
  • Other methods of treatment do not exclude probability of esophageal adenocarcinoma.
  • These children should be followed up with esophageal biopsy each 6-12 months.
  • [MeSH-major] Barrett Esophagus / etiology. Gastroesophageal Reflux / complications. Gastroesophageal Reflux / therapy
  • [MeSH-minor] Adolescent. Biopsy. Child. Child, Preschool. Combined Modality Therapy / standards. Diet, Reducing. Drug Therapy, Combination. Esophagoplasty / methods. Esophagus / drug effects. Esophagus / pathology. Esophagus / physiopathology. Esophagus / surgery. Female. Humans. Infant. Male. Metaplasia. Supine Position / physiology


7. Heath EI, Burtness BA, Heitmiller RF, Salem R, Kleinberg L, Knisely JP, Yang SC, Talamini MA, Kaufman HS, Canto MI, Topazian M, Wu TT, Olukayode K, Forastiere AA: Phase II evaluation of preoperative chemoradiation and postoperative adjuvant chemotherapy for squamous cell and adenocarcinoma of the esophagus. J Clin Oncol; 2000 Feb;18(4):868-76
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  • [Title] Phase II evaluation of preoperative chemoradiation and postoperative adjuvant chemotherapy for squamous cell and adenocarcinoma of the esophagus.
  • PURPOSE: This phase II trial evaluated continuous-infusion cisplatin and fluorouracil (5-FU) with radiotherapy followed by esophagectomy.
  • The objectives of this trial were to determine the complete pathologic response rate, survival rate, toxicity, pattern of failure, and feasibility of administering adjuvant chemotherapy in patients with resectable cancer of the esophagus treated with preoperative chemoradiation.
  • PATIENTS AND METHODS: Patients were staged using computed tomography, endoscopic ultrasound, and laparoscopy.
  • The preoperative treatment plan consisted of continuous intravenous infusion of cisplatin and 5-FU and a total dose of 44 Gy of radiation.
  • Paclitaxel and cisplatin were administered as postoperative adjuvant therapy.
  • Of the 39 patients who proceeded to surgery, 29 responded to preoperative treatment: 11 achieved pathologic complete response (CR) and 18 achieved a lower posttreatment stage.
  • Five patients had no change in stage, whereas eight had progressive disease (four with distant metastases and four with increases in the T and N stages).
  • At a median follow-up of 30.2 months, the median survival time has not been reached and the 2-year survival rate is 62%.
  • The median survival of pathologic complete responders has not been reached, whereas the 2-year survival rate of this group is 91% compared with 51% in patients with complete tumor resection with residual tumor (P =.03).
  • [MeSH-major] Adenocarcinoma / surgery. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / surgery. Esophagectomy. Neoadjuvant Therapy
  • [MeSH-minor] Adult. Aged. Antimetabolites, Antineoplastic / administration & dosage. Antimetabolites, Antineoplastic / adverse effects. Antineoplastic Agents / administration & dosage. Antineoplastic Agents / adverse effects. Antineoplastic Agents, Phytogenic / administration & dosage. Antineoplastic Agents, Phytogenic / adverse effects. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Cisplatin / adverse effects. Feasibility Studies. Female. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Paclitaxel / administration & dosage. Paclitaxel / adverse effects. Radiotherapy Dosage. Remission Induction. Survival Rate. Treatment Outcome

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  • (PMID = 10673530.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / 5P30CA0697337
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Phytogenic; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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8. O'Neil BH, Raftery L, Calvo BF, Chakravarthy AB, Ivanova A, Myers MO, Kim HJ, Chan E, Wise PE, Caskey LS, Bernard SA, Sanoff HK, Goldberg RM, Tepper JE: A phase I study of bortezomib in combination with standard 5-fluorouracil and external-beam radiation therapy for the treatment of locally advanced or metastatic rectal cancer. Clin Colorectal Cancer; 2010 Apr;9(2):119-25
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  • [Title] A phase I study of bortezomib in combination with standard 5-fluorouracil and external-beam radiation therapy for the treatment of locally advanced or metastatic rectal cancer.
  • BACKGROUND: Standard therapy for stage II/III rectal cancer consists of a fluoropyrimidine and radiation therapy followed by surgery.
  • The purpose of this study was to determine the maximum tolerated dose (MTD) of bortezomib in combination with chemotherapy and radiation.
  • Bortezomib was administered on days 1, 4, 8, and 11 every 21 days for 2 cycles with 5-fluorouracil at 225 mg/m2/day continuously and 50.4 Gy of radiation.
  • RESULTS: Nine patients in 2 dose cohorts were enrolled.
  • CONCLUSION: The MTD of bortezomib in combination with chemotherapy and radiation may be below a clinically relevant dose, limiting the clinical applicability of this combination.
  • Performing biopsies before and during irradiation for determining gene expression in response to radiation therapy is feasible.

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  • (PMID = 20378507.001).
  • [ISSN] 1938-0674
  • [Journal-full-title] Clinical colorectal cancer
  • [ISO-abbreviation] Clin Colorectal Cancer
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / P50 CA095103; United States / NCI NIH HHS / CA / K23 CA118431; United States / NCRR NIH HHS / RR / KL2 RR025746-02; None / None / / KL2 RR025746-02; United States / NCI NIH HHS / CA / P50CA106991; United States / NCI NIH HHS / CA / P30 CA068485; United States / NCRR NIH HHS / RR / UL1 RR024975; United States / NCI NIH HHS / CA / P50CA95103; United States / NCI NIH HHS / CA / P30CA068485; United States / NCI NIH HHS / CA / K23CA118431; United States / NCI NIH HHS / CA / P50 CA106991
  • [Publication-type] Clinical Trial, Phase I; Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents; 0 / Boronic Acids; 0 / NF-kappa B; 0 / Pyrazines; 69G8BD63PP / Bortezomib; U3P01618RT / Fluorouracil
  • [Other-IDs] NLM/ NIHMS200786; NLM/ PMC2893386
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9. Swisher SG, Pisters PW, Komaki R, Lahoti S, Ajani JA: Gastroesophageal junction adenocarcinoma. Curr Treat Options Oncol; 2000 Dec;1(5):387-98
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  • [Title] Gastroesophageal junction adenocarcinoma.
  • 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.
  • Additionally, a randomized phase III study evaluating preoperative chemotherapy without radiation therapy in esophageal cancer (predominantly adenocarcinoma) has demonstrated no survival benefit.
  • At the present time, preoperative chemoradiotherapy remains investigational.
  • For locoregionally advanced gastric adenocarcinoma, including AEG type III, postoperative concurrent 5-fluorouracil (5-FU)-based chemoradiotherapy is associated with improved survival as demonstrated in a recently completed random assignment trial (INT 0116).
  • As a result, surgery with postoperative chemoradiotherapy has recently become the standard of care for patients with AJCC stage II and III gastric adenocarcinoma (including patients with AEG type III).
  • Metastatic AEG (M1b) should be treated with palliative chemotherapy (in good performance patients) or supportive care (poor performance) in asymptomatic patients.
  • Radiation therapy and endoscopic stent placement (expandable wire mesh) can be used to palliate dysphagia in patients with M1b disease.
  • [MeSH-major] Adenocarcinoma / therapy. Esophageal Neoplasms / therapy. Esophagogastric Junction / pathology
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Esophagectomy. Humans. Neoplasm Staging. Radiotherapy

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  • (PMID = 12057146.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 47
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10. Osawa S, Yamada T, Iwaizumi M, Hamaya Y, Takagaki K, Nishino M, Kodaira C, Muramatsu A, Yoshida K, Sugimoto K, Futami H, Furuta T, Ikuma M: [A case of elderly esophageal adenocarcinoma successfully treated with daily low-dose nedaplatin (CDGP) and continuous infusion of 5-FU combined with radiation]. Gan To Kagaku Ryoho; 2009 Feb;36(2):309-12
Hazardous Substances Data Bank. FLUOROURACIL .

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  • [Title] [A case of elderly esophageal adenocarcinoma successfully treated with daily low-dose nedaplatin (CDGP) and continuous infusion of 5-FU combined with radiation].
  • We report an elderly patient with esophageal adenocarcinoma in whom a complete response (CR) was obtained by chemoradiotherapy using daily low-dose nedaplatin (CDGP) and continuous infusion of 5-FU.
  • A 86-year-old man who had non-tuberculous mycobacterial infection was admitted for dysphagia, and diagnosed with Stage II A (T2N0M0) esophageal adenocarcinoma of the lower esophagus according to the TNM classification (sixth edition) of the International Union against Cancer (UICC).
  • Chemoradiotherapy using daily low-dose CDGP and continuous infusion of 5- FU was performed, and thereafter one cycle of chemotherapy using CDGP and 5-FU was added.
  • As the side effects of treatment, grade 3 leucopenia was observed while he was receiving chemoradiotherapy.
  • A year later, he presented with grade 2 pericardial and pleural effusion and recovered with conservative treatment.
  • Definitive chemoradiotherapy using daily low-dose CDGP and continuous infusion of 5-FU is an effective choice for elderly and high-risk patients with esophageal adenocarcinoma.
  • [MeSH-major] Adenocarcinoma / drug therapy. Adenocarcinoma / radiotherapy. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy. Fluorouracil / therapeutic use. Organoplatinum Compounds / therapeutic use
  • [MeSH-minor] Aged, 80 and over. Combined Modality Therapy. Endoscopy, Gastrointestinal. Humans. Infusions, Intravenous. Male

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  • (PMID = 19223753.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Organoplatinum Compounds; 8UQ3W6JXAN / nedaplatin; U3P01618RT / Fluorouracil
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11. Liao Z, Zhang Z, Jin J, Ajani JA, Swisher SG, Stevens CW, Ho L, Smythe R, Vaporciyan AA, Putnam JB Jr, Walsh GL, Roth JA, Yao JC, Allen PK, Cox JD, Komaki R: Esophagectomy after concurrent chemoradiotherapy improves locoregional control in clinical stage II or III esophageal cancer patients. Int J Radiat Oncol Biol Phys; 2004 Dec 1;60(5):1484-93
Hazardous Substances Data Bank. FLUOROURACIL .

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  • [Title] Esophagectomy after concurrent chemoradiotherapy improves locoregional control in clinical stage II or III esophageal cancer patients.
  • PURPOSE: To evaluate the effect of surgical resection on the outcome of patients with clinical Stage II or III cancer of the esophagus treated with concurrent chemoradiotherapy.
  • METHODS AND MATERIALS: A retrospective review of 132 consecutive patients with clinical Stage II or III esophageal cancer treated with concurrent chemoradiotherapy between January 1990 and December 1998 was performed.
  • The median radiation dose was 50 Gy (range, 30-64.8 Gy) in the definitive chemoradiation group and 45 Gy (range, 30-50.4 Gy) in the chemoradiation plus esophagectomy group.
  • Patients who underwent definitive chemoradiotherapy were older (p = 0.0004) and more likely to have squamous cell carcinoma than adenocarcinoma (p <0.000), upper thoracic or cervical esophageal tumors (p <0.000), and T4 tumors (p = 0.024).
  • Patients treated with chemoradiation plus esophagectomy had statistically significant superior 5-year loco-regional control (67.1% vs. 22.1%, p <0.000), disease-free survival (40.7% vs. 9.9%, p < 0.000), and 5-year overall survival (52.6% vs. 6.5%, p < 0.000) rates and median survival time (62 vs. 12 months) compared with patients treated with chemoradiotherapy only.
  • CONCLUSIONS: Locoregional control was better in clinical Stage II or III esophageal cancer patients treated with concurrent chemoradiation plus esophagectomy.
  • The results from this study suggest the need for a randomized trial to compare chemoradiation with or without esophagectomy in the treatment of cancer of the esophagus.
  • [MeSH-major] Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / surgery. Esophagectomy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / pathology. Adenocarcinoma / radiotherapy. Adenocarcinoma / surgery. Adult. Aged. Aged, 80 and over. Analysis of Variance. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neoplasm Staging. Radiotherapy Dosage. Retrospective Studies. Treatment Failure

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  • (PMID = 15590179.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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12. Horgan AM, Darling G, Wong R, Visbal A, Guindi M, Jonker D, Liu G, Hornby J, Xu W, Knox JJ: Adjuvant sunitinib following chemoradiotherapy (CRT) and surgery for esophageal cancer: A phase II trial. J Clin Oncol; 2009 May 20;27(15_suppl):e15550

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Adjuvant sunitinib following chemoradiotherapy (CRT) and surgery for esophageal cancer: A phase II trial.
  • : e15550 Background: Locally advanced esophageal cancer (LAEC) has a 5-year survival of < 30 %.
  • Most patients (pts) fail after curative intent tri-modality treatment with distant metastatic disease.
  • This phase II trial aims to determine if adjuvant targeted therapy, after neoadjuvant CRT plus surgery for resectable LAEC, may impact on systemic disease without significant toxicity.
  • METHODS: Pts with LAEC of the thoracic esophagus or gastroesophageal junction, ECOG PS 0,1 and surgical candidates treated with: preoperative Irinotecan (65mg/m<sup>2</sup> initially, ammended to 50mg/m<sup>2</sup>) + Cisplatin (30mg/m<sup>2</sup>) on weeks 1,2,4,5,7,8 + concurrent conformal radiotherapy (50Gy/25 fractions) on weeks 4-8.
  • Median age 64 yr (43-71), male: 22, adenocarcinoma: squamous 22:6; 10 pts stage IIA, 5 IIB and 13 III.
  • 28 pts completed CRT - 18 pts (64%) received ≥80% of planned chemotherapy dose, 23 pts (82%) received full radiation dose.
  • 2 deaths on chemotherapy (1 bacterial meningitis, 1 FN) leading to irinotecan dose- reduction.
  • CONCLUSIONS: In LAEC, induction Irinotecan/Cisplatin and radiotherapy followed by esophagectomy is associated with a significant but manageable toxicity profile.

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  • (PMID = 27962341.001).
  • [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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13. Bubis JA, Williams I, Dragnev KH, Sutton JE, Gordon SR, Zaki BI, Cole BF, Rigas JR, Comprehensive Thoracic and Gastrointestinal Oncology Programs, Norris Cotton Cancer Center: Docetaxel (DTX) and carboplatin (CP) followed by a dose-ranging study of oral capecitabine, weekly DTX, concomitant radiotherapy and surgery for the treatment of patients with stage II-III carcinoma of the esophagus. J Clin Oncol; 2004 Jul 15;22(14_suppl):4049

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  • [Title] Docetaxel (DTX) and carboplatin (CP) followed by a dose-ranging study of oral capecitabine, weekly DTX, concomitant radiotherapy and surgery for the treatment of patients with stage II-III carcinoma of the esophagus.
  • : 4049 Background: We previously reported promising phase I data using neoadjuvant weekly DTX and 5-fluorouracil (5-FU) with thoracic irradiation followed by surgery in patients with locally advanced esophageal cancer.
  • METHODS: 18 patients with esophageal cancer (16 = adenocarcinoma, 2 = squamous) were consented and enrolled on this study.
  • Patients (Pts) were staged with a CT scan and endoscopic ultrasound (EUS).
  • Neoadjuvant therapy included DTX, 80 mg/M<sup>2</sup>, and CP, AUC 6, intravenously every three weeks for 2 cycles.
  • Subsequently, concomitant chemoradiotherapy (CXRT) was initiated with DTX, 15 mg/M<sup>2</sup>, weekly for five doses and C (7 = 500 mg, 3 = 1000 mg, 8 = 1500 mg) orally prior to each fraction of irradiation (50.4 Gy in 28 fractions).
  • RESULTS: Patient characteristics: EUS stage, 1 = T3N0, 2 = T2N1, 15 = T3N1.
  • Dose limiting toxicity (DLT), grade 3 dysphagia, occurred in 2 pts (1 = 300 mg, 1 = 1000 mg).
  • Only 3 pts required a feeding tube; 11 pts had weight gain over the course of therapy.
  • Antitumor response following chemotherapy and CXRT was 78% (95% confidence interval: 52%-94%) by EUS.
  • Pts have tolerated combined modality therapy well with minimal side effects, thereby allowing for weight gain without the need for a feeding tube in the majority of enrollees.

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  • (PMID = 28014356.001).
  • [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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14. Bader FG, Lordick F, Fink U, Becker K, Hofler H, Busch R, Siewert JR, Ott K: Paclitaxel in the neoadjuvant treatment for adeno carcinoma of the distal esophagus (AEG I). A comparison of two phase II trials with long-term follow-up. Onkologie; 2008 Jul;31(7):366-72
Hazardous Substances Data Bank. TAXOL .

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  • [Title] Paclitaxel in the neoadjuvant treatment for adeno carcinoma of the distal esophagus (AEG I). A comparison of two phase II trials with long-term follow-up.
  • INTRODUCTION: We report a comparative analysis of 2 sequential, prospective phase II trials on the efficacy of platinum/leucovorin/5-fluorouracil (PLF) +/- paclitaxel (T-PLF) in the neoadjuvant treatment of adenocarcinoma of the esophagus (AEG I).
  • PATIENTS AND METHODS: Inclusion criteria were histologically proven, locally advanced AEG I stage uT3/4 anyN cM0/M1a.
  • Median overall survival was better with T-PLF without reaching statistical significance (18.9 months PLF vs. 43.1 months T-PLF; p = 0.27).
  • No treatment-related deaths occurred.
  • CONCLUSION: Our data failed to demonstrate statistically significant superiority of the T-PLF regimen except for clinical response.
  • [MeSH-major] Adenocarcinoma / drug therapy. Clinical Trials, Phase II as Topic. Esophageal Neoplasms / drug therapy. Paclitaxel / administration & dosage
  • [MeSH-minor] Adult. Aged. Antineoplastic Agents, Phytogenic / administration & dosage. Antineoplastic Agents, Phytogenic / adverse effects. Chemotherapy, Adjuvant / methods. Female. Humans. Male. Middle Aged. Neoadjuvant Therapy / methods. Treatment Outcome

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  • [Copyright] (c) 2008 S. Karger AG, Basel
  • (PMID = 18596383.001).
  • [ISSN] 1423-0240
  • [Journal-full-title] Onkologie
  • [ISO-abbreviation] Onkologie
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Comparative Study; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; P88XT4IS4D / Paclitaxel
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15. Ruhstaller T, Templeton A, Ribi K, Schuller JC, Borner M, Thierstein S, von Moos R, Pederiva S, Lohri A, Lombriser N, von Briel C, Koeberle D, Popescu R: Intense therapy in patients with locally advanced esophageal cancer beyond hope for surgical cure: a prospective, multicenter phase II trial of the Swiss Group for Clinical Cancer Research (SAKK 76/02). Onkologie; 2010;33(5):222-8
NCI CPTC Antibody Characterization Program. NCI CPTC Antibody Characterization Program .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intense therapy in patients with locally advanced esophageal cancer beyond hope for surgical cure: a prospective, multicenter phase II trial of the Swiss Group for Clinical Cancer Research (SAKK 76/02).
  • BACKGROUND: There is no standard treatment for patients with locally advanced esophageal carcinoma without systemic metastasis in whom surgery is no longer considered a reasonable option.
  • PATIENTS AND METHODS: Patients with cervical esophageal tumors, locally very advanced stage (T4 and/or M1a) or locally advanced (T3 and/or N+) with comorbidities were included.
  • THERAPY: 2 cycles of induction chemotherapy (cisplatin and docetaxel, both 75 mg/m(2) 3-weekly) followed by chemoradiation therapy (CRT) comprising a total radiation dose of 59.4 Gy together with docetaxel 15 mg/m(2) and cisplatin 25 mg/m(2) (5 weekly doses).
  • Primary endpoint: Histologically proven freedom from local failure 6 months after CRT completion.
  • RESULTS: 21 patients were included: 12 had locally very advanced tumors, 3 had cervical esophagus tumors, and 6 were medically unfit for surgery.
  • 18 patients completed therapy per protocol.
  • Most patients experienced lasting improvement of dysphagia following induction chemotherapy.
  • [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. Radiotherapy, Conformal
  • [MeSH-minor] Aged. Combined Modality Therapy. Disease-Free Survival. Drug Administration Schedule. Feasibility Studies. Female. Humans. Lymphatic Metastasis / pathology. Male. Middle Aged. Neoplasm Staging. Prospective Studies. Radiotherapy Dosage

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  • [Copyright] Copyright 2010 S. Karger AG, Basel.
  • [CommentIn] Onkologie. 2010;33(5):220-1 [20502055.001]
  • (PMID = 20502056.001).
  • [ISSN] 1423-0240
  • [Journal-full-title] Onkologie
  • [ISO-abbreviation] Onkologie
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] Switzerland
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16. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The national practice for patients receiving radiation therapy for carcinoma of the esophagus: results of the 1996-1999 Patterns of Care Study.
  • PURPOSE: A Patterns of Care Study (PCS) was conducted to evaluate the standards of practice for patients receiving radiation therapy for esophageal cancer from 1996 to 1999.
  • This study examined the evaluation and treatment schemes used during this time and compared these results to the PCS data obtained between 1992 and 1994 to identify any fundamental changes in national practice.
  • METHODS: A national survey was conducted using a two-stage cluster sampling technique.
  • Specific information was collected on 414 patients with esophageal cancer who received radiotherapy (RT) as part of definitive or adjuvant management at 59 institutions.
  • Patients were staged according to the 1983 AJCC.
  • Eligibility criteria for case review included RT between 1996 and 1999, no evidence of distant metastasis (including CT evidence of either supraclavicular or celiac nodes >1 cm), squamous cell or adenocarcinoma histology, Karnofsky performance status >60, tumors in the thoracic esophagus with <2 cm extension into the stomach, and no prior malignancies within the last 5 years.
  • Statistical analysis was performed on the database using SUDAAN software to accurately reflect the type of sampling technique used by PCS.
  • For the purposes of comparison, the 1992-1994 PCS esophageal survey results were subjected to the same statistical procedures and tests.
  • A review of the histology revealed a nearly 50:50 split between squamous cell and adenocarcinoma.
  • Sixteen percent were clinical Stage I, 39% clinical Stage II, and 33% clinical Stage III according to the 1983 AJCC system.
  • Fifty-six percent of patients received concurrent chemoradiation as definitive treatment.
  • Forty-six percent of patients with adenocarcinoma underwent trimodality therapy as compared to 19% with squamous cell carcinomas (p = 0.0002).
  • The median total dose of external RT was 50.4 Gy, and the median dose per fraction was 1.8 Gy.
  • The chemotherapy agents most commonly used included 5-fluorouracil (82%), cisplatin (67%), and paclitaxel (22%).
  • Paclitaxel was more commonly employed as part of a preoperative chemoradiation regimen than in the setting of definitive chemoradiation (46% vs. 12%, p = 0.03).
  • CONCLUSIONS: The Patterns of Care Survey confirms the use of concurrent chemoradiation as part of the national standards of practice for the management of esophageal cancer patients.
  • [MeSH-major] Adenocarcinoma / radiotherapy. Benchmarking. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / radiotherapy. Practice Patterns, Physicians'

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  • (PMID = 12829133.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA65435
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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17. Heath EI, Burtness BA, Kleinberg L, Salem RR, Yang SC, Heitmiller RF, Canto MI, Knisely JP, Topazian M, Montgomery E, Tsottles N, Pithavala Y, Rohmiller B, Collier M, Forastiere AA: Phase II, parallel-design study of preoperative combined modality therapy and the matrix metalloprotease (mmp) inhibitor prinomastat in patients with esophageal adenocarcinoma. Invest New Drugs; 2006 Mar;24(2):135-40
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  • [Title] Phase II, parallel-design study of preoperative combined modality therapy and the matrix metalloprotease (mmp) inhibitor prinomastat in patients with esophageal adenocarcinoma.
  • PURPOSE: This randomized phase II, parallel-design study evaluated preoperative combined modality therapy and the matrix metalloprotease (MMP) inhibitor prinomastat in patients with resectable adenocarcinoma of the esophagus that were stage II or greater.
  • PATIENTS AND METHODS: Preoperative staging included computed tomography, endoscopic ultrasound, and, when feasible, laparoscopy.
  • Fourteen patients, 7 in each arm, completed preoperative treatment and surgery. pCR was achieved in 5 patients; 1/ 7 prinomastat and 4/ 7 placebo.
  • This toxicity was managed with treatment rest, dose reduction, or discontinuation.
  • CONCLUSIONS: All patients, regardless of treatment arm, were able to successfully undergo neoadjuvant combined modality therapy and esophagectomy.
  • However, early closure of the study due to unexpected thrombo-embolic events precluded any conclusions regarding clinical activity of prinomastat in locally advanced esophageal cancer patients.
  • [MeSH-major] Adenocarcinoma / drug therapy. Esophageal Neoplasms / drug therapy. Matrix Metalloproteinase Inhibitors. Organic Chemicals / therapeutic use. Protease Inhibitors / therapeutic use
  • [MeSH-minor] Combined Modality Therapy. Esophagectomy. Humans. Male. Middle Aged. Neoadjuvant Therapy / adverse effects. Neoplasm Staging. Thromboembolism / chemically induced

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  • (PMID = 16502351.001).
  • [ISSN] 0167-6997
  • [Journal-full-title] Investigational new drugs
  • [ISO-abbreviation] Invest New Drugs
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Randomized Controlled Trial
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Matrix Metalloproteinase Inhibitors; 0 / Organic Chemicals; 0 / Protease Inhibitors; 10T6626FRK / prinomastat
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18. Coia LR, Minsky BD, Berkey BA, John MJ, Haller D, Landry J, Pisansky TM, Willett CG, Hoffman JP, Owen JB, Hanks GE: Outcome of patients receiving radiation for cancer of the esophagus: results of the 1992-1994 Patterns of Care Study. J Clin Oncol; 2000 Feb;18(3):455-62
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  • [Title] Outcome of patients receiving radiation for cancer of the esophagus: results of the 1992-1994 Patterns of Care Study.
  • PURPOSE: A Patterns of Care Study examined the records of patients with esophageal cancer (EC) treated with radiation in 1992 through 1994 to determine the national practice processes of care and outcomes and to compare the results with those of clinical trials.
  • PATIENTS AND METHODS: A national survey of 63 institutions was conducted using two-stage cluster sampling, and specific information was collected on 400 patients with squamous cell (62%) or adenocarcinoma (37%) of the thoracic esophagus who received radiation therapy (RT) as part of primary or adjuvant treatment.
  • Fifteen percent of patients had clinical stage (CS) I disease, 40% had CS II disease, and 30% had CS III disease.
  • Seventy-five percent of patients received chemotherapy; 84% of these received concurrent chemotherapy and radiation (CRT).
  • RESULTS: Significant variables for overall survival in multivariate analysis include the use of esophagectomy (risk ratio [RR] = 0.62), the use of chemotherapy (RR = 0.63), Karnofsky performance status (KPS) greater than 80 (RR = 0.61), CS I or II disease (RR = 0.66), and facility type (RR = 0.72).
  • Preoperative CRT resulted in a nonsignificantly higher 2-year survival rate compared with definitive CRT alone (63% v 39%; P =.11), whereas 2-year survival by planned treatment rather than treatment given was 47.7% for preoperative CRT and 35.4% for definitive CRT (P =.23).
  • Definitive CRT compared with definitive RT alone resulted in significantly higher 2-year survival (39% v 20.6%; P =.027) and lower 2-year local regional failure (30% v 57.9%; P =. 0031).
  • CONCLUSION: This study confirms the value of CRT in EC treatment.
  • The suggested value of esophagectomy and superiority of preoperative CRT over CRT alone in this study should be tested in a randomized trial.
  • [MeSH-major] Adenocarcinoma / radiotherapy. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Clinical Trials as Topic. Cluster Analysis. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / pathology. Survival Analysis. Treatment Outcome

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  • [CommentIn] J Clin Oncol. 2000 Feb;18(3):453-4 [10653859.001]
  • (PMID = 10653860.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Multicenter Study
  • [Publication-country] United States
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19. Taylor MD, Smith PW, Brix WK, Wick MR, Theodosakis N, Swenson BR, Kozower BD, Jones DR: Correlations between selected tumor markers and fluorodeoxyglucose maximal standardized uptake values in esophageal cancer. Eur J Cardiothorac Surg; 2009 Apr;35(4):699-705
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  • [Title] Correlations between selected tumor markers and fluorodeoxyglucose maximal standardized uptake values in esophageal cancer.
  • OBJECTIVE: Esophageal cancer tumor biology is best assessed clinically by 2-[18F]fluoro-2-deoxy-d-glucose (FDG)-PET.
  • Both FDG-PET maximal positron emission tomography (PET) standardized uptake values (SUVmax) and selected tumor markers have been shown to correlate with stage, nodal disease, and survival in esophageal cancer.
  • Interestingly, there is limited data examining the relationship between FDG-PET SUVmax and expression of these tumor markers in esophageal cancer.
  • The purpose of this study was to determine the correlation of tumor markers with FDG-PET SUVmax in esophageal cancer.
  • METHODS: FDG-PET SUVmax was calculated in 67 patients with esophageal cancer of which 59 (88%) had adenocarcinoma.
  • Neoadjuvant radiotherapy and/or chemotherapy were administered to 42% (28/67) of patients.
  • Esophageal tumor tissue and surrounding normal tissue was obtained and tissue microarrays were created.
  • Immunohistochemical analysis was performed for five known esophageal cancer tumor markers (GLUT-1, p53, cyclin D1, epidermal growth factor receptor (EGFR), and vascular endothelial growth factor (VEGF)).
  • RESULTS: There were 55 men (82%) and 12 women (18%) with a median age of 63 years (range 40-83).
  • Pathologic staging included stage I (n=29, 43%), stage II (n=19, 28%), stage III disease (n=18, 27%), and stage IV disease (n=1, 2%).
  • PET SUVmax correlated with T stage (p=0.001).
  • In patients undergoing surgery without induction therapy, increasing SUVmax values correlated with increased expression of GLUT-1 transporter (p=0.01).
  • CONCLUSIONS: FDG-PET SUVmax correlates with an increased expression of GLUT-1 transporter in esophageal cancer specimens not subjected to induction therapy.
  • No significant difference in tumor marker expression was noted between patients undergoing induction therapy or surgery alone except p53 expression decreased in primary tumors following induction therapy.
  • Failure of SUVmax values to correlate with known prognostic esophageal cancer tumor markers suggests that FDG-PET may have limited clinical utility in assessing response to therapies targeting these markers.

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  • (PMID = 19136271.001).
  • [ISSN] 1873-734X
  • [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
  • [Grant] United States / NHLBI NIH HHS / HL / HL007849-09; United States / NHLBI NIH HHS / HL / T32 HL007849; United States / NHLBI NIH HHS / HL / T32 HL007849-09
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Glucose Transporter Type 1; 0 / Neoplasm Proteins; 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
  • [Other-IDs] NLM/ NIHMS189314; NLM/ PMC2878130
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20. Kleinberg L, Knisely JP, Heitmiller R, Zahurak M, Salem R, Burtness B, Heath EI, Forastiere AA: Mature survival results with preoperative cisplatin, protracted infusion 5-fluorouracil, and 44-Gy radiotherapy for esophageal cancer. Int J Radiat Oncol Biol Phys; 2003 Jun 1;56(2):328-34
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  • [Title] Mature survival results with preoperative cisplatin, protracted infusion 5-fluorouracil, and 44-Gy radiotherapy for esophageal cancer.
  • PURPOSE: To assess the long-term survival results after cisplatin, protracted infusion 5-fluorouracil, and concurrent radiotherapy (RT) followed by surgical resection of esophageal cancer.
  • METHODS AND MATERIALS: Ninety-two patients with esophageal cancer (65 with adenocarcinoma and 27 with squamous cell carcinoma) were treated in two sequential protocols of preoperative chemoradiotherapy.
  • The patients had tumor confined to the esophagus and regional nodes, including celiac nodes for middle and distal lesions.
  • In trial A (1989-1994), 50 patients were treated with 44 Gy RT (2 Gy/d) along with concurrent 5-fluorouracil 300 mg/m(2)/d given by protracted venous infusion on Days 1-30 and cisplatin 26 mg/m(2) on Days 1-5 and 26-30.
  • In trial B (1995-1997, 42 patients), the chemotherapy dosages during RT were reduced to 5-fluorouracil 225 mg/m(2)/d protracted venous infusion and cisplatin 20 mg/m(2)/d on Days 1-5 and 16-30; three cycles of paclitaxel 135 mg/m(2)and cisplatin 75 mg/m(2) were given postoperatively.
  • Surgery generally occurred 4-6 weeks after completion of the planned preoperative therapy.
  • RESULTS: Of the 92 patients, 86 (93%) underwent surgery (1 refused, 2 died preoperatively, and 3 developed evidence of metastatic disease).
  • Patients with a pathologic complete response had a 67% survival rate at 5 years (median not reached), and the remainder of patients had a 5-year survival rate of 27% (median 21 months; p <0.001).
  • Eight patients with pathologic Stage I tumor at the time of surgery had survival similar to those with a complete response to preoperative therapy.
  • The median survival for patients with pathologic Stage IIA, IIB, III, and IV disease at the time of surgery was 22, 13.5, 18, and 4.9 months, respectively.
  • The pattern of initial failure was local/regional alone in 6% (5 of 90), local/regional plus distant in 3% (3 of 90), and distant alone in 47% (42 of 90).
  • No differences were noted in survival or response rate between those with adenocarcinoma or squamous cell carcinoma.
  • CONCLUSION: The promising 5-year survival results and low rate of late cancer-related deaths suggest that these regimens of intensive neoadjuvant therapy may improve the overall cure rate.
  • The pathologic stage after neoadjuvant therapy is an important predictor of survival and may be useful in selecting patients for novel adjuvant therapies.
  • Isolated local failure is uncommon, indicating that efforts to improve the therapeutic outcome should focus on optimizing systemic therapy rather than intensifying the RT.
  • Additional randomized data are needed to assess the benefits of this therapeutic approach fully.
  • [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. Esophagectomy. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Proportional Hazards Models. Survival Rate

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  • (PMID = 12738305.001).
  • [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] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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21. Stein HJ, Feith M, Siewert JR: Cancer of the esophagogastric junction. Surg Oncol; 2000 Jul;9(1):35-41
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  • In the Western world, there has been an alarming rise in the incidence and prevalence of adenocarcinoma arising at the esophagogastric junction during recent decades.
  • Epidemiological, clinical and pathological data support a sub-classification of adenocarcinomas arising in the vicinity of the esophagogastric junction (AEG) into adenocarcinoma of the distal esophagus (Type I), true carcinoma of the cardia (Type II) and subcardial carcinoma (Type III).
  • While most, if not all, adenocarcinomas of the distal esophagus arise from areas with specialized intestinal metaplasia, which develop as a consequence of chronic gastroesophageal reflux, the etiology and pathogenesis of true carcinoma of the gastric cardia and subcardial gastric cancer is not clear at present.
  • Irrespective of the etiology, a complete removal of the primary tumor and its lymphatic drainage has to be the primary goal of any surgical approach to adenocarcinoma of the esophagogastric junction.
  • Our experience in the management of more than 1000 such patients during the past 18 years suggests that an individualized therapeutic strategy oriented by tumor type and stage results in survival rates superior to those reported with a more indiscriminate approach.
  • This individualized strategy prescribes a transmediastinal esophagectomy with lymphadenectomy in the lower posterior mediastinum and along the celiac axis for Type I tumors, extended total gastrectomy with transhiatal resection of the distal esophagus and D2 lymphadenectomy for Type II and Type III tumors, a limited resection of the esophagogastric junction and distal esophagus with interposition of a pedicled jejunal segment for uT1N0 tumors, and neoadjuvant chemotherapy followed by resection for uT3/T4 tumors.
  • Extensive preoperative staging is essential to allow correct selection of the appropriate therapeutic strategy using this tailored approach.
  • [MeSH-major] Adenocarcinoma / diagnosis. Adenocarcinoma / therapy. Esophageal Neoplasms / diagnosis. Esophageal Neoplasms / therapy. Esophagogastric Junction. Stomach Neoplasms / diagnosis. Stomach Neoplasms / therapy
  • [MeSH-minor] Algorithms. Combined Modality Therapy. Decision Trees. Esophagectomy. Gastrectomy. Gastroesophageal Reflux / complications. Humans. Incidence. Lymph Node Excision. Neoplasm Staging. Preoperative Care. Prevalence. Splenectomy. Survival Analysis. Treatment Outcome

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  • (PMID = 11525305.001).
  • [ISSN] 0960-7404
  • [Journal-full-title] Surgical oncology
  • [ISO-abbreviation] Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Netherlands
  • [Number-of-references] 36
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22. An FS, Huang JQ, Xie YT, Chen SH, Rong TH: [A prospective study of combined chemoradiotherapy followed by surgery in the treatment of esophageal carcinoma]. Zhonghua Zhong Liu Za Zhi; 2003 Jul;25(4):376-9
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  • [Title] [A prospective study of combined chemoradiotherapy followed by surgery in the treatment of esophageal carcinoma].
  • OBJECTIVE: To evaluate the effect of combined chemoradiotherapy followed by surgery for patients with esophageal carcinoma.
  • METHODS: Ninety-seven patients with stage II or III esophageal carcinoma without contraindication against operation and chemoradiotherapy, were randomly divided into two groups: combined group (Group A) 48 and control group (Group B) 49.
  • Patients in group A were given neoadjuvant treatment consisted of chemotherapy with 5-fluorouracil and cisplatin for 2 cycles and radiotherapy of DT36 Gy/12 f/17 d.
  • The T stage of group A was significantly lowered (P = 0.003 6).
  • The local and regional recurrence rate of two groups were 34.8% and 58.7% (P = 0.023 6), while there was no significant difference in operative complications between the two groups.
  • CONCLUSION: Preoperative neoadjuvant chemoradiotherapy is able to reduce the tumor and tumor stage, lower the lymph node metastasis rate and local or regional recurrence rate, also it can improve radical resectability and long-term survival without increasing the operative complications.
  • [MeSH-major] Adenocarcinoma. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell. Esophageal Neoplasms
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Esophagectomy. Female. Fluorouracil / administration & dosage. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Particle Accelerators. Prospective Studies. Radiotherapy, Adjuvant. Survival Rate

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  • (PMID = 12921571.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] Clinical Trial; English Abstract; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] China
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; CF regimen
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23. Mücke R, Ziegler PG, Libera T, Klautke G, Fietkau R: [The multimodality therapy of advanced inoperable esophageal carcinoma. A retrospective analysis]. Strahlenther Onkol; 2000 Aug;176(8):350-5
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  • [Title] [The multimodality therapy of advanced inoperable esophageal carcinoma. A retrospective analysis].
  • [Transliterated title] Multimodale Therapie des fortgeschrittenen inoperablen Osophaguskarzinoms. Eine retrospektive Analyse.
  • BACKGROUND: The records of 161 patients with inoperable esophageal carcinoma were reviewed to determine the influence of concurrent radiochemotherapy and brachytherapy on overall survival.
  • PATIENTS AND METHODS: From 1984 to 1999 161 patients suffering from advanced esophageal carcinoma Stage II to IV were treated with radiotherapy alone (131) or radiochemotherapy (30).
  • Median follow-up was 8 months (1 to 64 months), the median external beam doses was 51 Gy (18 to 66.6 Gy) and the median brachytherapy dose was 10 Gy (4 to 25 Gy).
  • Chemotherapy consisted of cisplatin and 5-fluorouracil.
  • In univariate analysis the best results were achieved by concurrent radiochemotherapy with a median overall survival of 13 months, a 4-year survival of 18% (p = 0.0368), the combination of external radiotherapy and additional brachytherapy with a median overall survival of 14 months, a 4-year survival of 12.2% (p = 0.0008).
  • After combination of concurrent radiochemotherapy and brachytherapy the 2-year survival rate is 58%.
  • Combination of concurrent radiochemotherapy and brachytherapy was possible without significant increase of local toxicity.
  • CONCLUSIONS: Our retrospective analysis demonstrates that concurrent radiochemotherapy and additional brachytherapy are effective treatment schedules without significant increase of toxicity and may improve overall survival of patients with inoperable carcinoma of the esophagus.
  • [MeSH-major] Adenocarcinoma / therapy. Carcinoma, Squamous Cell / therapy. Esophageal Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Brachytherapy. Chemotherapy, Adjuvant. Female. Follow-Up Studies. Humans. Male. Middle Aged. Multivariate Analysis. Neoplasm Staging. Radiotherapy Dosage. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis

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  • (PMID = 10987017.001).
  • [ISSN] 0179-7158
  • [Journal-full-title] Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]
  • [ISO-abbreviation] Strahlenther Onkol
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] GERMANY
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24. Liang Z, Hu WD, Gu ZD, Xiong HC, Chen KN: [Evaluation of transhiatus esophagectomy for patients with esophageal cancer]. Zhonghua Wei Chang Wai Ke Za Zhi; 2008 Sep;11(5):451-3
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  • [Title] [Evaluation of transhiatus esophagectomy for patients with esophageal cancer].
  • OBJECTIVE: To evaluate the transhiatus esophagectomy for patients with esophageal cancer.
  • METHODS: Clinicopathological data of 46 patients with esophageal cancer undergone transhiatus esophagectomy by single surgeon team from May 2000 to July 2007 were analyzed retrospectively.
  • RESULTS: These 46 patients included 44 esophageal squamous cell carcinomas,1 esophageal adenocarcinoma and 1 esophageal carcinoid.
  • All the patients were classified according to UICC TNM stage classification: 3 cases as stage 0, 6 cases as stage I, 17 cases as stage II a, 2 cases as stage II b, 16 cases as stage III.
  • Six patients received preoperative chemotherapy and pathological complete response was seen in 2 cases.
  • CONCLUSION: Transhiatus esophagectomy is an ideal choice in surgical treatment for patients with esophageal cancer, especially for the ones of aged, poor cardiac or pulmonary function, who can not afford the thoracotomy.
  • [MeSH-major] Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / surgery. Esophagectomy / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Esophagus / surgery. Female. Humans. Male. Middle Aged. Retrospective Studies

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  • (PMID = 18803048.001).
  • [ISSN] 1671-0274
  • [Journal-full-title] Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery
  • [ISO-abbreviation] Zhonghua Wei Chang Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Evaluation Studies; Journal Article
  • [Publication-country] China
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25. 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.
  • With a median follow-up of 45 months, the median survival is 22 months (95% CI = 15-32 months), with actuarial 1-, 2-, and 3-year survivals of 71%, 47%, and 41%, respectively.
  • 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.
  • These results, obtained in a community-based setting and involving multiple surgeons, radiation oncologists, and medical oncologists, compare favorably with those of previous single-center and multicenter results.
  • [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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26. Yamashita H, Nakagawa K, Tago M, Igaki H, Nakamura N, Shiraishi K, Sasano N, Ohtomo K: Radiation therapy combined with cis-diammine-glycolatoplatinum (nedaplatin) and 5-fluorouracil for Japanese stage II-IV esophageal cancer compared with cisplatin plus 5-fluorouracil regimen: a retrospective study. Dis Esophagus; 2006;19(1):15-9
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  • [Title] Radiation therapy combined with cis-diammine-glycolatoplatinum (nedaplatin) and 5-fluorouracil for Japanese stage II-IV esophageal cancer compared with cisplatin plus 5-fluorouracil regimen: a retrospective study.
  • To evaluate the treatment outcome of radiotherapy combined with cis-diammine-glycolatoplatinum (nedaplatin) plus 5-fluorouracil (5-FU) for esophageal cancer.
  • From January 2000 to December 2004, a total of 12 esophageal cancer patients with locally advanced and metastatic esophageal cancer (stages II-IVB) were treated with radiation therapy (50.4 Gy) combined with nedaplatin (80 mg/m(2), bolus infusion) and 5-FU (800 mg/m(2)/24 h, continuous infusion for 4 days) (NDP group).
  • We compared the data with those of patients during the same period receiving a different chemotherapy regimen consisting of cisplatin (75 mg/m(2), bolus infusion) and 5-FU (1000 mg/m(2)/24 h, continuous infusion for 4 days) (n = 29, CDDP group) combined with the same radiation therapy.
  • Radiation combined with nedaplatin and 5-FU is a safe and effective method for treating esophageal cancer.

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  • (PMID = 16364038.001).
  • [ISSN] 1120-8694
  • [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] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Organoplatinum Compounds; 8UQ3W6JXAN / nedaplatin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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27. Knox JJ, Wong R, Visbal AL, Horgan AM, Guindi M, Hornby J, Xu W, Ringash J, Keshavjee S, Chen E, Haider M, Darling G: Phase 2 trial of preoperative irinotecan plus cisplatin and conformal radiotherapy, followed by surgery for esophageal cancer. Cancer; 2010 Sep 1;116(17):4023-32
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  • [Title] Phase 2 trial of preoperative irinotecan plus cisplatin and conformal radiotherapy, followed by surgery for esophageal cancer.
  • BACKGROUND: Esophagectomy for locally advanced esophageal cancer (LAEC) is associated with limited survival.
  • Trimodality therapy yields a small survival advantage, with cisplatin and 5-fluorouracil regimens most frequently studied.
  • METHODS: Patients with LAEC of the thoracic esophagus or gastroesophageal junction underwent chemotherapy with preoperative irinotecan (65 mg/m(2)) plus cisplatin (30 mg/m(2)) on Weeks 1, 2, 4, 5, 7, and 8 with concurrent conformal radiotherapy (40 grays [Gy]/20 fractions during Weeks 4-7) and external beam boost (10 Gy/5 fractions at Week 8).
  • Nineteen patients had American Joint Committee on Cancer stage II, 22 had stage III, and 11 had stage IVA disease.
  • Three patients withdrew from treatment due to toxicity.
  • There was 1 treatment-related death.
  • Clinical responses included complete response in 2%, partial response in 30%, stable disease in 62%, and progressive disease in 6% of patients.
  • Median and 3-year overall survival for patients receiving trimodality therapy was 36 months and 51%, respectively.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Camptothecin / analogs & derivatives. Cisplatin / administration & dosage. Esophageal Neoplasms / therapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / surgery. Adult. Aged. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Carcinoma, Squamous Cell / surgery. Combined Modality Therapy. Esophagectomy. Esophagogastric Junction. Female. Humans. Male. Middle Aged. Neoadjuvant Therapy. Radiotherapy, Conformal

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  • [Copyright] Cancer 2010. (c) 2010 American Cancer Society.
  • (PMID = 20533506.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 7673326042 / irinotecan; Q20Q21Q62J / Cisplatin; XT3Z54Z28A / Camptothecin
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28. Stein HJ, Feith M, Siewert JR: Individualized surgical strategies for cancer of the esophagogastric junction. Ann Chir Gynaecol; 2000;89(3):191-8
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  • Due to their borderline location between the stomach and esophagus the optimal surgical strategy for patients with adenocarcinoma of the esophagogastric junction is controversial.
  • Irrespective of the surgical approach a complete removal of the primary tumor and its lymphatic drainage has to be the primary goal of surgical treatment of such tumors.
  • Based on the experience with surgical resection of more than 1000 patients with adenocarcinoma of the esophagogastric junction we recommend an individualized surgical strategy guided by tumor stage and topographic location of the tumor center or tumor mass.
  • This requires detailed preoperative staging and classification of tumors arising in the vicinity of the esophagogastric junction into adenocarcinoma of the distal esophagus (AEG Type I Tumors), true carcinoma of the gastric cardia (AEG Type II Tumors) and subcardial gastric carcinoma infiltrating the esophagogastric junction (AEG Type III Tumors).
  • In patients with Type I Tumors transthoracic esophagectomy offers no survival benefit over radical transmediastinal esophagectomy, but is associated with higher morbidity.
  • In patients with Type II or Type III tumors an extended total gastrectomy results in equal or superior survival and less postoperative mortality than a more extended esophagogastrectomy.
  • In patients with early tumors, staged as uT1 on preoperative endosonography, a limited resection of the proximal stomach, cardia and distal esophagus with interposition of a pedicled isoperistaltic jejunal segment allows a complete tumor removal with adequate lymphadenectomy and offers excellent functional results.
  • Multimodal treatment protocols with neoadjuvant chemotherapy or combined radiochemotherapy followed by surgical resection appear to markedly improve the prognosis in patients with locally advanced tumors who respond to preoperative treatment.
  • With this tailored approach extensive preoperative staging becomes mandatory for an adequate selection of the appropriate therapeutic concept.
  • [MeSH-major] Adenocarcinoma / surgery. Carcinoma / surgery. Cardia. Esophageal Neoplasms / surgery. Esophagogastric Junction. Stomach Neoplasms / surgery
  • [MeSH-minor] Algorithms. Chemotherapy, Adjuvant. Clinical Trials, Phase III as Topic. Combined Modality Therapy. Endoscopy. Esophagectomy. Esophagus / pathology. Gastrectomy. Gastric Fundus / surgery. Humans. Neoplasm Staging. Palliative Care. Prognosis. Radiotherapy, Adjuvant. Randomized Controlled Trials as Topic. Stomach / pathology. Time Factors

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  • (PMID = 11079787.001).
  • [ISSN] 0355-9521
  • [Journal-full-title] Annales chirurgiae et gynaecologiae
  • [ISO-abbreviation] Ann Chir Gynaecol
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Review
  • [Publication-country] FINLAND
  • [Number-of-references] 26
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29. Daly JM, Fry WA, Little AG, Winchester DP, McKee RF, Stewart AK, Fremgen AM: Esophageal cancer: results of an American College of Surgeons Patient Care Evaluation Study. J Am Coll Surg; 2000 May;190(5):562-72; discussion 572-3
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  • [Title] Esophageal cancer: results of an American College of Surgeons Patient Care Evaluation Study.
  • BACKGROUND: The last two decades have seen changes in the prevalence, histologic type, and management algorithms for patients with esophageal cancer.
  • The purpose of this study was to evaluate the presentation, stage distribution, and treatment of patients with esophageal cancer using the National Cancer Database of the American College of Surgeons.
  • STUDY DESIGN: Consecutively accessed patients (n = 5,044) with esophageal cancer from 828 hospitals during 1994 were evaluated in 1997 for case mix, diagnostic tests, and treatment modalities.
  • RESULTS: The mean age of patients was 67.3 years with a male to female ratio of 3:1; non-Hispanic Caucasians made up most patients.
  • Approximately 50% of patients had the tumor in the lower third of the esophagus.
  • Of all patients, 51.6% had squamous cell histology and 41.9% had adenocarcinoma.
  • Barrett's esophagus occurred in 777 patients, or 39% of those with adenocarcinoma.
  • Of those patients that underwent surgery initially, pathology revealed stage I (13.3%), II (34.7%), III (35.7%), and IV (12.3%) disease.
  • For patients with various stages of squamous cell cancer, radiation therapy plus chemotherapy were the most common treatment modalities (39.5%) compared with surgery plus adjuvant therapy (13.2%).
  • For patients with adenocarcinoma, surgery plus adjuvant therapy were the most common treatment methods.
  • CONCLUSIONS: Cancer of the esophagus shows an increasing occurrence of adenocarcinoma in the lower third of the esophagus and is frequently associated with Barrett's esophagus.
  • Choice of treatment was influenced by tumor histology and tumor site.
  • Multimodality (neoadjuvant) therapy was the most common treatment method for patients with esophageal adenocarcinoma.
  • The use of multimodality treatment did not appear to increase postoperative morbidity.
  • [MeSH-major] Esophageal Neoplasms / surgery
  • [MeSH-minor] Aged. Combined Modality Therapy. Esophagus / pathology. Esophagus / radiography. Female. General Surgery. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / epidemiology. Neoplasm Staging. Postoperative Complications / epidemiology. Registries / statistics & numerical data. Societies, Medical. Tomography, X-Ray Computed. Treatment Outcome. United States

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  • (PMID = 10801023.001).
  • [ISSN] 1072-7515
  • [Journal-full-title] Journal of the American College of Surgeons
  • [ISO-abbreviation] J. Am. Coll. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
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30. Low DE, Kunz S, Schembre D, Otero H, Malpass T, Hsi A, Song G, Hinke R, Kozarek RA: Esophagectomy--it's not just about mortality anymore: standardized perioperative clinical pathways improve outcomes in patients with esophageal cancer. J Gastrointest Surg; 2007 Nov;11(11):1395-402; discussion 1402
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  • [Title] Esophagectomy--it's not just about mortality anymore: standardized perioperative clinical pathways improve outcomes in patients with esophageal cancer.
  • BACKGROUND: Esophageal resection (ER) remains the standard therapy for early esophageal cancer; however, because of concerns regarding high levels of morbidity and mortality reported in analyses of national databases, many patients are relegated to less effective endoscopic or chemotherapeutic approaches.
  • All aspects of work-up and treatment were guided by an evolving standardized perioperative clinical pathway.
  • RESULTS: Three hundred forty consecutive patients, mean age of 64 (33-90), underwent ER for Barrett's esophagus (17) or invasive cancer stages I-87, II-133, III-94, IV-9.
  • One hundred thirty-nine (41%) had neoadjuvant therapy.
  • Patient were managed intraoperatively with a "fluid restriction" protocol.
  • No significant differences were seen in length of stay, operative time, blood loss, or complications in patients receiving neoadjuvant therapy.
  • For stages I, II, and III, patients between 1998-2004 Kaplan-Meier 5-year cumulative survival was 92.4, 57.1, and 34.5%, respectively.
  • CONCLUSIONS: Surgical treatment of esophageal cancer can be done with moderate morbidity and very low mortality, and the expectation of improved levels of survival, especially in early-stage patients.
  • Standardized perioperative clinical pathways can provide the infrastructure for the treatment of these patients and should include increased efforts to minimize blood loss and transfusions, improve postoperative pain control and extubation rates, and facilitate early mobilization and discharge.
  • ER, as sole therapy or in combination with radiation/chemotherapy, should remain the standard of care in patients with early and locoregional esophageal cancer.
  • [MeSH-major] Adenocarcinoma / mortality. Adenocarcinoma / surgery. Carcinoma, Squamous Cell / mortality. Carcinoma, Squamous Cell / surgery. Critical Pathways. Esophageal Neoplasms / mortality. Esophageal Neoplasms / surgery. Esophagectomy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Barrett Esophagus / surgery. Blood Loss, Surgical. Female. Humans. Length of Stay. Male. Middle Aged. Neoadjuvant Therapy. Neoplasm Staging. Prognosis. Treatment Outcome

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  • (PMID = 17763917.001).
  • [ISSN] 1091-255X
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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31. Geissler M, Schwacha H, Eggstein S, Usadel H, Harder J, Opitz O, Arnold C, Grimm CF, Blum HE: [Esophageal carcinoma: non-surgical therapy]. Praxis (Bern 1994); 2004 Dec 1;93(49):2057-64
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  • [Title] [Esophageal carcinoma: non-surgical therapy].
  • [Transliterated title] Osophaguskarzinom--Nicht-chirurgische Therapie.
  • Esophageal carcinoma is one of the most common cancers in the world.
  • There is a rising incidence of adenocarcinoma of the esophagus in Western countries.
  • Surgical treatment of stage II patients with locally resectable tumors is associated with poor survival figures due to an increase of regional and distant lymph node metastases.
  • Adjuvant chemotherapy should be used only in the setting of clinical trials.
  • There is also evidence that some patients with a complete response after chemo-radiotherapy do not have a further benefit from surgical treatment.
  • Therefore, the appropriate application of these varied therapeutic interventions should be performed at specialized centers.
  • The role of chemotherapy and radiation is now established in locally advanced inoperable disease.
  • How best to deliver these modes of therapy has yet to be defined.
  • Prospective randomised trials are the only way to define the best therapeutic strategies for the different subgroups of patients with esophageal carcinoma.
  • Progress with newer chemotherapy agents, optimal radiotherapy protocols and innovations are likely to improve responses to combination treatments, but may more importantly limit associated toxicity.
  • Future trials should also assess quality of life indices as end points, that are of particular importance in populations with a median survival of approx, one year.
  • Patients with stage IVb esophageal carcinoma have a life expectancy of less than six months and palliative teatment strategies should primarily aim at the improvement of tumor related symptoms and the maintenance of nutrition.
  • [MeSH-major] Esophageal Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Agents / administration & dosage. Antineoplastic Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brachytherapy. Combined Modality Therapy. Esophagus / pathology. Female. Humans. Incidence. Male. Neoplasm Staging. Palliative Care. Photochemotherapy. Prognosis. Quality of Life. Radiotherapy Dosage. Randomized Controlled Trials as Topic. Stents. Time Factors

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  • (PMID = 15630988.001).
  • [ISSN] 1661-8157
  • [Journal-full-title] Praxis
  • [ISO-abbreviation] Praxis (Bern 1994)
  • [Language] ger
  • [Publication-type] Comparative Study; English Abstract; Journal Article; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 25
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32. Oettle H, Arnold D, Kern M, Hoepffner N, Settmacher U, Neuhaus P, Riess H: Phase I study of gemcitabine in combination with cisplatin, 5-fluorouracil and folinic acid in patients with advanced esophageal cancer. Anticancer Drugs; 2002 Sep;13(8):833-8
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  • [Title] Phase I study of gemcitabine in combination with cisplatin, 5-fluorouracil and folinic acid in patients with advanced esophageal cancer.
  • The prognosis for advanced esophageal carcinoma is poor with a median survival of 9-12 months and 5-year-survival rate of 10-20%.
  • Combination chemotherapy with cisplatin and 5-fluorouracil (5-FU) is considered to be the standard therapy, but has a high potential of side effects and is usually not given on an ambulatory basis.
  • All drugs were to be given on a day 1, 8, 15 and 22 of a 6-weekly cycle in an outpatient setting.
  • Nineteen chemonaive patients with inoperable stage IIa, III and IV squamous cell carcinoma and adenocarcinoma of the esophagus were enrolled into the study.
  • Eight, six and five patients were enrolled at cisplatin dose levels 0 (20 mg/m(2) ), I (25 mg/m(2) ) and II (30 mg/m(2)), respectively.
  • One hundred and eighty-one out of 187 treatments (55 cycles) were given on an outpatient basis.
  • Dose level II (30 mg/m(2)) was defined as the MTD for cisplatin when used in this combination and schedule.
  • The side effect profile seen in this study in combination with the preliminary evidence of efficacy justifies further testing in a phase II setting with a cisplatin dose of 25 mg/m(2) and offers a treatment option for patients in an outpatient setting.
  • [MeSH-major] Adenocarcinoma / drug therapy. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Deoxycytidine / analogs & derivatives. Esophageal Neoplasms / drug therapy

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  • (PMID = 12394268.001).
  • [ISSN] 0959-4973
  • [Journal-full-title] Anti-cancer drugs
  • [ISO-abbreviation] Anticancer Drugs
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine; Q20Q21Q62J / Cisplatin; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil
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33. Jost C, Binek J, Schuller JC, Bauerfeind P, Metzger U, Werth B, Knuchel J, Frossard JL, Bertschinger P, Brauchli P, Meyenberger C, Ruhstaller T: Endosonographic radial tumor thickness after neoadjuvant chemoradiation therapy to predict response and survival in patients with locally advanced esophageal cancer: a prospective multicenter phase ll study by the Swiss Group for Clinical Cancer Research (SAKK 75/02). Gastrointest Endosc; 2010 Jun;71(7):1114-21
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  • [Title] Endosonographic radial tumor thickness after neoadjuvant chemoradiation therapy to predict response and survival in patients with locally advanced esophageal cancer: a prospective multicenter phase ll study by the Swiss Group for Clinical Cancer Research (SAKK 75/02).
  • BACKGROUND: EUS response assessment in patients with locally advanced esophageal cancer undergoing neoadjuvant chemoradiation therapy (CRT) is limited by disintegration of the involved anatomic structures.
  • PATIENTS: Of 66 patients with primary CRT, 56 underwent en bloc esophagectomy.
  • Characteristics (n = 40) were as follow: median age, 60 years; squamous cell carcinoma, 42%; and adenocarcinoma (AC), 58%.
  • Initial stage was: 10 T2N1, 3 T3N0, 26 T3N1, 1 T3Nx; 14 of 23 AC Siewert type 1.
  • CONCLUSION: In a multicenter setting, MTT measured by EUS after CRT was highly predictive for response and showed a clear trend for predicting survival.
  • [MeSH-major] Cisplatin / therapeutic use. Endosonography / methods. Esophageal Neoplasms / ultrasonography. Esophagus / ultrasonography. Taxoids / therapeutic use
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / mortality. Adenocarcinoma / radiotherapy. Adenocarcinoma / ultrasonography. Adult. Aged. Antineoplastic Agents / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / mortality. Carcinoma, Squamous Cell / radiotherapy. Carcinoma, Squamous Cell / ultrasonography. Disease Progression. Drug Therapy, Combination. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoadjuvant Therapy. Neoplasm Staging / methods. Predictive Value of Tests. Prospective Studies. Radiation-Sensitizing Agents / therapeutic use. Survival Rate / trends. Treatment Outcome

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  • [Copyright] Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
  • (PMID = 20304399.001).
  • [ISSN] 1097-6779
  • [Journal-full-title] Gastrointestinal endoscopy
  • [ISO-abbreviation] Gastrointest. Endosc.
  • [Language] eng
  • [Databank-accession-numbers] ClinicalTrials.gov/ NCT00072033
  • [Publication-type] Clinical Trial, Phase II; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Radiation-Sensitizing Agents; 0 / Taxoids; 15H5577CQD / docetaxel; Q20Q21Q62J / Cisplatin
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34. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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35. Takemura M, Osugi H, Lee S, Taguchi S, Kaneko M, Tanaka Y, Fukuhara K, Fujiwara Y, Nishizawa S, Kinoshita H, Harada S: [A case of synchronous esophageal and gastric cancer successfully treated by combination TS-1/CDDP therapy with irradiation]. Gan To Kagaku Ryoho; 2004 Feb;31(2):251-4
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  • [Title] [A case of synchronous esophageal and gastric cancer successfully treated by combination TS-1/CDDP therapy with irradiation].
  • We report a case of synchronous esophageal and gastric cancer in a patient with severe liver dysfunction who was treated successfully using TS-1/CDDP therapy combined with irradiation therapy.
  • A 56-year-old man with a chief complaint of dysphagia was diagnosed with thoracic esophageal cancer by endoscopy, and was referred to our hospital.
  • Synchronous esophageal and gastric cancer were diagnosed by endoscopy and barium swallow.
  • The preoperative diagnosis was T3N0M0, Stage II esophageal cancer and T1N0M0, Stage I A gastric cancer, both of which were diagnosed to be resectable.
  • TS-1 (80 mg/day) and CDDP (3 mg/day) therapy was combined with irradiation, 60 Gy given in a T-pattern to the mediastinum.
  • The patient did not suffer any side-effects, and endoscopy performed 44 days after the start of treatment showed that the esophageal lesion was now only a scar.
  • Only a slight elevation of the esophagus was seen by endoscopy 219 days after the start of the therapy.
  • The patient is currently undergoing only TS-1 treatment as an outpatient and is under observation.
  • TS-1 and CDDP therapy combined with radiotherapy appears to be effective in treating thoracic esophageal cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy. Neoplasms, Multiple Primary. Stomach Neoplasms / drug therapy. Stomach Neoplasms / radiotherapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / radiotherapy. Administration, Oral. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Cisplatin / administration & dosage. Combined Modality Therapy. Drug Administration Schedule. Drug Combinations. Humans. Male. Middle Aged. Oxonic Acid / administration & dosage. Pyridines / administration & dosage. Radiotherapy Dosage. Tegafur / administration & dosage

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  • (PMID = 14997762.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Drug Combinations; 0 / Pyridines; 150863-82-4 / S 1 (combination); 1548R74NSZ / Tegafur; 5VT6420TIG / Oxonic Acid; Q20Q21Q62J / Cisplatin
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36. Khushalani NI, Leichman CG, Proulx G, Nava H, Bodnar L, Klippenstein D, Litwin A, Smith J, Nava E, Pendyala L, Smith P, Greco W, Berdzik J, Douglass H, Leichman L: Oxaliplatin in combination with protracted-infusion fluorouracil and radiation: report of a clinical trial for patients with esophageal cancer. J Clin Oncol; 2002 Jun 15;20(12):2844-50
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Oxaliplatin in combination with protracted-infusion fluorouracil and radiation: report of a clinical trial for patients with esophageal cancer.
  • PURPOSE: To identify a dose and schedule of oxaliplatin (OXP) to be safely administered in combination with protracted-infusion (PI) fluorouracil (5-FU) and external-beam radiation therapy (XRT) for patients with primary esophageal carcinoma (EC).
  • PATIENTS AND METHODS: Eligibility included therapeutically naïve EC patients with clinical disease stages II, III, or IV.
  • Initial doses and schedules for cycle 1 consisted of OXP 85 mg/m(2) on days 1, 15, and 29; PI 5-FU 180 mg/m(2) for 24 hours for 35 days; and XRT 1.8 Gy in 28 fractions starting on day 8.
  • Stage IV patients were allowed three cycles in the absence of disease progression.
  • RESULTS: Thirty-eight eligible patients received therapy: 22 noninvasively staged as IV and 16 noninvasively staged as II and III.
  • The combined-modality therapy was well tolerated, but DLT prevented OXP and 5-FU escalation.
  • After cycle 1, 29 patients (81%) had no cancer in the esophageal mucosa.
  • Thirteen patients underwent an operation with intent to resect the esophagus; five patients (38%) exhibited pathologic complete responses.
  • [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. Aged, 80 and over. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Infusions, Intravenous. Male. Middle Aged. Neoadjuvant Therapy. Organoplatinum Compounds / administration & dosage. Treatment Outcome

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  • (PMID = 12065561.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 16056; United States / NCI NIH HHS / CA / CA 9154901
  • [Publication-type] Clinical Trial; Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Organoplatinum Compounds; 04ZR38536J / oxaliplatin; U3P01618RT / Fluorouracil
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