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Items 1 to 39 of about 39
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.
  • 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.
  • A complete pathologic response was seen in 11% of all patients and in 25% of those with epidermoid cancer.
  • CONCLUSION: Paclitaxel-carboplatin combination is a safe and well-tolerated regimen for esophageal cancer with clinical response rates comparable to historical controls.
  • This regimen may be especially suitable for patients with epidermoid cancer, who had a 25% pathological complete response in this report.
  • [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. Adelstein DJ, Rice TW, Rybicki LA, Saxton JP, Videtic GM, Murthy SC, Mason DP, Rodriguez CP, Ives DI: Mature results from a phase II trial of postoperative concurrent chemoradiotherapy for poor prognosis cancer of the esophagus and gastroesophageal junction. J Thorac Oncol; 2009 Oct;4(10):1264-9
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  • [Title] Mature results from a phase II trial of postoperative concurrent chemoradiotherapy for poor prognosis cancer of the esophagus and gastroesophageal junction.
  • INTRODUCTION: Mature results are presented from a phase II trial of postoperative concurrent chemoradiotherapy in patients with poor-prognosis cancer of the esophagus and gastroesophageal junction after primary surgical resection.
  • METHODS: Resected patients with a pathologic stage of T3, N1, or M1a were eligible for this trial.
  • Concurrent chemoradiotherapy was begun between 6 and 10 weeks after surgery and consisted of radiotherapy (1.8 Gy/d to a planned dose of 50.4-59.4 Gy), concurrent with two cycles of 5-fluorouracil (1000 mg/m/d) and cisplatin (20 mg/m/d), both given as 4-day continuous intravenous infusions during the first and fourth weeks of the radiation.
  • With a median follow-up of 47 (range, 36-124) months, the Kaplan-Meier 4-year projected overall survival is 51%, freedom from recurrence 50%, distant metastatic control 56%, and locoregional control 86%.
  • An earlier pathologic stage was the only predictor for a better outcome.
  • CONCLUSIONS: This schedule of postoperative concurrent chemoradiotherapy has acceptable toxicity for patients with poor-prognosis esophageal and gastroesophageal junction cancer after surgery.
  • [MeSH-major] Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy. Esophagogastric Junction / pathology. Stomach Neoplasms / drug therapy. Stomach Neoplasms / radiotherapy
  • [MeSH-minor] Adenocarcinoma / pathology. Adenocarcinoma / therapy. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / therapy. Cisplatin / administration & dosage. Esophagectomy. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neoplasm Staging. Postoperative Period. Prospective Studies. Radiotherapy Dosage. Survival Rate. Treatment Outcome

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  • (PMID = 19668013.001).
  • [ISSN] 1556-1380
  • [Journal-full-title] Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
  • [ISO-abbreviation] J Thorac Oncol
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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4. Yano M, Shiozaki H, Tsujinaka T, Inoue M, Doki Y, Fujiwara Y, Monden M: Squamous cell carcinoma of the esophagus infiltrating the respiratory tract is less sensitive to preoperative concurrent radiation and chemotherapy. J Am Coll Surg; 2000 Dec;191(6):626-34
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  • [Title] Squamous cell carcinoma of the esophagus infiltrating the respiratory tract is less sensitive to preoperative concurrent radiation and chemotherapy.
  • BACKGROUND: The prognosis of upper thoracic esophageal cancer is poor when compared with middle and lower thoracic esophageal cancer because the tumor easily infiltrates the respiratory tract and surgical en-bloc resection is difficult.
  • Recently, preoperative chemoradiation therapy has been shown to lead to down-staging of the disease and improve prognosis.
  • But the benefit of this therapy for tumors infiltrating the respiratory tract remains unknown.
  • STUDY DESIGN: Fifty-six patients with thoracic esophageal cancer infiltrating neighboring organs, but with no hematogeneous metastasis, were given preoperative concurrent chemotherapy (5-fluorouracil and cisplatin) and radiation (40 Gy) therapy.
  • Patients positive for respiratory tract invasion (T, T + A), compared with those negative for respiratory tract invasion (A, Oth), showed a poorer clinical response to chemoradiation (3.0%, 45.5%, 39.4%, and 9.1% versus 4.3%, 82.6%, 4.3%, and 8.7% in complete response (CR), partial response (PR), nonresponse (NC) and progressive disease (PD), respectively, p = 0.0156) and surgical resectability (36.4% vs. 87.0%, p = 0.0003).
  • Histologic effectiveness (8.3%, 50.0%, and 41.7% versus 25.0%, 70.0%, and 5.0% in grade 3, grade 2, and grade 1, respectively, for patients with respiratory tract invasion versus those without it, p = 0.0189) and histologic stages (8.3%, 8.3%, 8.3%, 8.3%, 25.0%, and 41.7% versus 20.0%, 0%, 15.0%, 25.0%, 40.0%, and 0% in pathologic CR, stage I, stage IIA, stage IIB, stage III, and stage IV, respectively, for patients with respiratory tract invasion versus those without it, p = 0.0496) were significantly better in patients negative for respiratory tract invasion; the percentages of patients with lymph node metastasis did not differ significantly between the two groups.
  • Comparison of the recurrence patterns showed that local failure was most common in patients with respiratory tract invasion, and distant failure was the leading cause of recurrence in patients without it.
  • CONCLUSIONS: Because the prognosis of patients with thoracic esophageal cancer infiltrating the respiratory tract is extremely poor, partially because of the low local effectiveness of preoperative concurrent chemotherapy and radiation therapy, caution is needed when deciding on salvage surgery.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / secondary. Carcinoma, Squamous Cell / therapy. Drug Tolerance. Esophageal Neoplasms / pathology. Esophagectomy. Preoperative Care / methods. Radiation Tolerance. Respiratory Tract Neoplasms / secondary. Respiratory Tract Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Lymph Node Excision. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Recurrence, Local / pathology. Neoplasm Staging. Prognosis. Proportional Hazards Models. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 11129811.001).
  • [ISSN] 1072-7515
  • [Journal-full-title] Journal of the American College of Surgeons
  • [ISO-abbreviation] J. Am. Coll. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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5. Anderson SE, Minsky BD, Bains M, Hummer A, Kelsen D, Ilson DH: Combined modality chemoradiation in elderly oesophageal cancer patients. Br J Cancer; 2007 Jun 18;96(12):1823-7
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  • [Title] Combined modality chemoradiation in elderly oesophageal cancer patients.
  • We present a single institution experience with 5-FU, mitomycin-C based chemoradiation for the primary treatment of elderly patients with oesophageal cancer.
  • Twenty-five patients with a median age of 77 years (range 66-88) with a diagnosis of stage II-III squamous cell or adenocarcinoma of the oesophagus were treated at Memorial Sloan Kettering from 1996 to 2001 with two cycles of concurrent 5-FU, mitomycin-C and 50.4 Gy.
  • Of the 23 patients evaluable for response, 17 patients (68%) had a negative post-treatment endoscopy and CT scan without evidence of progressive disease.
  • Eleven patients (44%) are alive and 10 (40%) remain without evidence of recurrent or progressive oesophageal cancer at a median follow-up of 35 months.
  • There was no significant difference in overall survival between Charlson score </=2 and those with a score >/=2 (P=0.10).
  • Similar survival was observed for patients with adenocarcinoma or squamous carcinoma.
  • Primary chemoradiation with two cycles of 5-FU, mitomycin-C, and 50.4 Gy in elderly patients is an active regimen with moderate toxicity, despite the advanced age and heavy comorbidity burden of this cohort.
  • Patients with local/regional oesophageal cancer with adequate functional status should not be excluded from potentially curative treatment based on age alone.
  • [MeSH-major] Adenocarcinoma / drug therapy. Adenocarcinoma / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Fluorouracil / administration & dosage. Humans. Mitomycin / administration & dosage. Survival Analysis

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  • (PMID = 17533399.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
  • [Other-IDs] NLM/ PMC2359964
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6. Aoyama N, Koizumi H, Minamide J, Yoneyama K, Isono K: Prognosis of patients with advanced carcinoma of the esophagus with complete response to chemotherapy and/or radiation therapy: a questionnaire survey in Japan. Int J Clin Oncol; 2001 Jun;6(3):132-7
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  • [Title] Prognosis of patients with advanced carcinoma of the esophagus with complete response to chemotherapy and/or radiation therapy: a questionnaire survey in Japan.
  • BACKGROUND: We estimated the survival of patients with advanced carcinoma of the esophagus in Japan who achieved complete response (CR) with chemotherapy and/or radiation therapy.
  • METHODS: A questionnaire was designed for patients with cancer of the esophagus with pretreatment stage II-IV (excluding organ metastasis [M1]), who were treated with chemotherapy and/or radiation therapy and achieved either a clinical CR continuing for more than 1 year, or a pathological CR in surgical specimens.
  • In each of groups A and B, there was no significant difference in overall survival among subgroups of patients classified by initial pretreatment clinical stage.
  • In group A, the survival rate of patients with concurrent chemotherapy and radiation therapy was significantly better than the rates for patients with chemotherapy alone or radiotherapy alone.
  • In group A, the frequency of first failure at the local site of esophageal carcinoma was 7.7%.
  • CONCLUSION: The effect of CR to chemotherapy and/or radiation therapy for carcinoma of the esophagus on survival was marked.
  • In patients with esophageal carcinoma who achieve CR, the prognosis may be independent of the initial pretreatment stage.
  • Local failure in group A patients remains a problem, however.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Female. Follow-Up Studies. Health Surveys. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Prognosis. Survival Analysis. Treatment Outcome

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  • (PMID = 11706782.001).
  • [ISSN] 1341-9625
  • [Journal-full-title] International journal of clinical oncology
  • [ISO-abbreviation] Int. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
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7. 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.
  • Grade 3 to 4 toxicity (graded according to the National Cancer Institute Common Toxicity Criteria 2.0) during induction included neutropenia (36%), febrile neutropenia (8%), diarrhea (10%), and esophagitis (4%).
  • 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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8. Kii T, Takiuchi H, Kawabe S, Gotoh M, Ohta S, Tanaka T, Kuwakado S, Nishitani H, Katsu K: Evaluation of prognostic factors of esophageal squamous cell carcinoma (stage II-III) after concurrent chemoradiotherapy using biopsy specimens. Jpn J Clin Oncol; 2007 Aug;37(8):583-9
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  • [Title] Evaluation of prognostic factors of esophageal squamous cell carcinoma (stage II-III) after concurrent chemoradiotherapy using biopsy specimens.
  • BACKGROUND: Recently, attention has been directed to concurrent chemoradiotherapy (CRT) for the treatment of squamous cell carcinoma of the esophagus with regard to efficacy, quality of life and functional preservation, and survival periods comparable to those after standard surgical therapy have been reported in responders to CRT.
  • However, there are some non-responders to CRT, and the prediction of the outcome after CRT is an important subject for future studies.
  • who were histologically confirmed to have squamous cell carcinoma of the esophagus at stage II or III (UICC).
  • Concurrent CRT consisting of chemotherapy using 5FU and CDDP and radiation therapy (60 Gy) was performed as the initial treatment, and the relationships of overexpression of EGFR, p53, VEGF, PCNA and CyclinD1 were examined immunohistochemically in biopsy specimens collected before treatment.
  • On multivariate analysis, T stage (P = 0.0393) and PCNA (P = 0.0302) were found to be significant prognostic factors.
  • CONCLUSIONS: PCNA overexpression appears to be a prognostic factor for squamous cell carcinoma of the esophagus after CRT.
  • [MeSH-major] Carcinoma, Squamous Cell / mortality. Carcinoma, Squamous Cell / therapy. Esophageal Neoplasms / mortality. Esophageal Neoplasms / therapy
  • [MeSH-minor] Aged. Antineoplastic Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biopsy. Combined Modality Therapy. Cyclin D1 / analysis. Cyclophosphamide / therapeutic use. Doxorubicin / therapeutic use. Etoposide / therapeutic use. Female. Fluorouracil / therapeutic use. Humans. Male. Prognosis. Proliferating Cell Nuclear Antigen / analysis. Receptor, Epidermal Growth Factor / analysis. Tumor Suppressor Protein p53 / analysis


9. Matsutani T, Sasajima K, Maruyama H, Suzuki S, Miyamoto M, Yokoyama T, Yanagi K, Matsushita A, Matsuda A, Tajiri T: [A case of the oldest old patient with advanced esophageal cancer responding completely to the combination chemotherapy of docetaxel/5-fluorouracil/nedaplatin with radiation]. Nihon Shokakibyo Gakkai Zasshi; 2009 Jul;106(7):1026-30
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  • [Title] [A case of the oldest old patient with advanced esophageal cancer responding completely to the combination chemotherapy of docetaxel/5-fluorouracil/nedaplatin with radiation].
  • Endoscopic examination revealed an advanced esophageal cancer located in the lower thoracic esophagus.
  • Histological analysis revealed moderately differentiated squamous cell carcinoma.
  • The clinical stage was diagnosed as T2N0M0, stage II.
  • He received radiation therapy in combination with chemotherapy using docetaxel, 5-fluorouracil and nedaplatin.
  • After chemoradiotherapy (CRT), the carcinoma could not be detected by CT or endoscopy, and endoscopic biopsy revealed no cancer cells in categorization as resulting complete response.
  • Adverse event consisted of grade 2 in leukopenia.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Esophageal Neoplasms / drug therapy

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  • (PMID = 19578310.001).
  • [ISSN] 0446-6586
  • [Journal-full-title] Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology
  • [ISO-abbreviation] Nihon Shokakibyo Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents; 0 / Organoplatinum Compounds; 0 / Taxoids; 15H5577CQD / docetaxel; 8UQ3W6JXAN / nedaplatin; U3P01618RT / Fluorouracil
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10. 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%.
  • [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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11. Yamamoto G, Shimada T, Nishida T, Ishida Y, Iba T, Nakata T, Ohtsuki T, Takigami K, Yamaguchi Y, Yoshitake K, Tanaka A, Tsuda Y: [Evaluation of a combination chemotherapy with nedaplatin and 5-FU for oral cancers]. Gan To Kagaku Ryoho; 2001 Aug;28(8):1111-5
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  • [Title] [Evaluation of a combination chemotherapy with nedaplatin and 5-FU for oral cancers].
  • Nedaplatin (cis-diammine-glycolato platinum: CDGP) is a platinum compound with a molecular weight of 303.18 that was recently developed in Japan.
  • There have been reports of the antineoplastic effects of Nedaplatin on cancers in the cranio-cervical region, lung, esophagus, urinary bladder, testis, ovary, and uterus.
  • In this study, we performed combined therapy of CDGP and fluorouracil (5-FU) for 8 patients with oral cancers, and evaluated the results to elucidate the clinical effect and adverse side effects.
  • The subjects were 8 patients with squamous cell carcinoma (5 males and 3 females aged 33-65 years).
  • The primary carcinoma regions were the tongue in 5 patients, oral floor in 2 patients, and mandibular gingiva in 1 patient.
  • The T-classification was T2 in 6 patients and T4 in 2 patients, and the clinical staging was Stage II in 5 patients, Stage III in 1 patient and Stage IV in 2 patients.
  • The adverse side effects were slight myelotoxicity, gagging, nausea, alopecia, and stomatitis less than Grade II.
  • Although the oral cancers in this study were extroverted superficial ulcerative cancers, and the number of patients was low at 8, this combined therapy is considered useful and worth evaluating in further accumulated cases.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Mouth Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Drug Administration Schedule. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Organoplatinum Compounds / administration & dosage. Remission Induction

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  • (PMID = 11525027.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Clinical Trial; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Organoplatinum Compounds; 8UQ3W6JXAN / nedaplatin; U3P01618RT / Fluorouracil
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12. Kelsen DP: Neoadjuvant therapy of squamous cell carcinoma of the esophagus. Recent Results Cancer Res; 2000;155:105-12
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  • [Title] Neoadjuvant therapy of squamous cell carcinoma of the esophagus.
  • Because of the high risk of recurrence following surgery for squamous cell carcinomas of the esophagus, treatment involving both systemic therapy and a localized approach [either surgery alone or chemo/radiation and surgery] have been extensively studied.
  • Pilot trials have demonstrated safety for the use of chemotherapy followed by operation, or for chemotherapy plus standard radiation plus surgery.
  • For chemotherapy followed by surgery, conflicting results have recently been noted.
  • However, recently newer chemotherapy agents have been identified which hold promise for more effective therapy.
  • Phase II trials, using these agents prior to surgery, are underway or have been completed, and phase III studies are in the advanced planning stage.
  • Until these trials have demonstrated superiority, surgery alone or chemoradiation without surgery remain the standard of care, for patients with esophageal cancer.
  • [MeSH-major] Carcinoma, Squamous Cell / therapy. Esophageal Neoplasms / therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Combined Modality Therapy. Humans. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 10693243.001).
  • [ISSN] 0080-0015
  • [Journal-full-title] Recent results in cancer research. Fortschritte der Krebsforschung. Progrès dans les recherches sur le cancer
  • [ISO-abbreviation] Recent Results Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] GERMANY
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13. Seitz JF, Milan C, Giovannini M, Dumas F, Cauvin JM, Conroy T, François E, Renard P, Votte-Lambert A, Paillot B, Bedenne L, Fondation Française de Cancérologie Digestive, Groupe Digestif de la Fédération Nationale des Centres de Lutte Contre le Cancer: [Concurrent concentrated radio-chemotherapy of epidermoid cancer of the esophagus. Long-term results of a phase II national multicenter trial in 122 non-operable patients (FFCD 8803)]. Gastroenterol Clin Biol; 2000 Feb;24(2):201-10
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  • [Title] [Concurrent concentrated radio-chemotherapy of epidermoid cancer of the esophagus. Long-term results of a phase II national multicenter trial in 122 non-operable patients (FFCD 8803)].
  • [Transliterated title] Radio-chimiothérapie concomitante concentrée des cancers épidermoïdes de l'oesophage. Résultats à long terme d'un essai national multicentrique de phase II chez 122 malades non opérables (FFCD 8803).
  • OBJECTIVES: Concomitant radiochemotherapy improves survival from inoperable esophageal cancer compared to radiotherapy alone.
  • METHODS: This multicentric phase II trial looked at patients with histologically proven, inoperable, squamous cell esophageal carcinoma without metastases or invasion of the tracheobronchial mucosa.
  • Treatment included 3 cycles of chemotherapy by 5-FU continuous infusion (800 mg/m2.d D1-D5, D22-D26, D43-D47), cisplatin (70 mg/m2 D2, D23, D44) and radiotherapy 15 Gy/5d (D1-D5, D22-26, D43-D47).
  • Efficacy was analyzed by endoscopy, biopsy and computerized axial tomography during the 12th week of treatment.
  • In accordance with the TNM-UICC classification (1978), 8 patients were classified stage I (T1 N0), 13 stage II (T2 N0), 100 stage III (T3 and/or N1) and stage was unknown in 1 patient.
  • Treatment was complete in half of the patients.
  • 5 premature deaths (4.1%) were recorded over the treatment period, one of which was directly linked to the toxicity of the treatment.
  • 117 patients received all 3 cycles of the treatment, 88 of them without delay, and all were evaluated.
  • 58 (47.5% of the patients included) showed a complete response with a negative biopsy, 36 (29.5%) showed a partial response, 13 (10.7%) were stable and 10 (8.2%) showed progressive disease.
  • At evaluation, oral feeding was impossible in 4 patients only and possible in 113 patients; however, endoscopic treatment of the dysphagia remained necessary in 28 patients.
  • Three pretherapeutic prognostic factors influenced survival in a multivariate analysis: initial severe dysphagia (risk of premature death increased 3-fold in the first year), circumferential extension and the differentiated nature of the tumor (risk of death doubled regardless of the time delay).
  • Factors influencing a complete clinical response were an early tumor stage, a poorly differenciated tumor in patients older than 65, and no circumferential extension.
  • CONCLUSION: This trial confirms the efficacy and good tolerance of concentrated split course radiochemotherapy in patients with inoperable esophageal cancer with a 5-year survival rate of 12%.
  • [MeSH-major] Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Survival Rate. Time Factors

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  • (PMID = 12687962.001).
  • [ISSN] 0399-8320
  • [Journal-full-title] Gastroentérologie clinique et biologique
  • [ISO-abbreviation] Gastroenterol. Clin. Biol.
  • [Language] fre
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; English Abstract; Journal Article; Multicenter Study
  • [Publication-country] France
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14. Sun KL, He J, Cheng GY, Chai LX: Management of primary small cell carcinoma of the esophagus. Chin Med J (Engl); 2007 Mar 5;120(5):355-8
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  • [Title] Management of primary small cell carcinoma of the esophagus.
  • BACKGROUND: Primary small cell carcinoma of the esophagus is rare.
  • Although surgery is successful in eradicating local tumor, the five-year survival rate of patients with primary small cell carcinoma of the esophagus after resection is lower than that of patients with primary squamous cell carcinoma of the esophagus.
  • The purpose of this study was to analyze the clinical manifestations, pathological features and treatment of primary small cell carcinoma of the esophagus.
  • METHODS: A total of 73 patients with primary small cell carcinoma of the esophagus who had been treated by surgery from 1984 to 2003 were analyzed retrospectively.
  • CONCLUSIONS: Primary small cell carcinoma of the esophagus is rare with a poor prognosis.
  • Surgical resection is the leading method for patients with stage I or II primary small cell carcinoma of the esophagus.
  • Postoperative chemotherapy is beneficial to these patients.
  • The patients of stage III or IV should be given chemotherapy and radiation therapy.
  • [MeSH-major] Carcinoma, Small Cell / therapy. Esophageal Neoplasms / therapy

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  • (PMID = 17376302.001).
  • [ISSN] 0366-6999
  • [Journal-full-title] Chinese medical journal
  • [ISO-abbreviation] Chin. Med. J.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China
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15. Kwong DL, Law SY, Tong DK, Wong KH, Nicholls J: COX-2 inhibition in combination with preoperative chemoradiation for CA esophagus. J Clin Oncol; 2009 May 20;27(15_suppl):e15607

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] COX-2 inhibition in combination with preoperative chemoradiation for CA esophagus.
  • : e15607 Background: Squamous cell carcinoma of the thoracic esophagus (ESCC) is often diagnosed in advanced stage.
  • The primary and involved lymph nodes are irradiated to 40Gy in 20 fractions over 4 weeks with 2 cycles of concurrent cisplatin (100mg/sqm, D1, D22) and 5 fluorouracil (500mg/sqm, D1-5, D22-26).
  • Pre-operative staging was stage II in 4, stage III in 25 and stage IVA in 3 patients.
  • 3 patients did not have full course of celecoxib: 1 complained of epigastric pain, 1 died early of disease, 1 had renal impairment after chemotherapy.
  • Incorporation of COX-2 inhibition into multi-modality treatment of ESCC should be further investigated in a randomized trial.

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  • (PMID = 27962685.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Cao XF, He XT, Ji L, Xiao J, Lv J: Effects of neoadjuvant radiochemotherapy on pathological staging and prognosis for locally advanced esophageal squamous cell carcinoma. Dis Esophagus; 2009;22(6):477-81
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  • [Title] Effects of neoadjuvant radiochemotherapy on pathological staging and prognosis for locally advanced esophageal squamous cell carcinoma.
  • The role of neoadjuvant therapy in the treatment of locally advanced esophageal carcinoma still remains controversial.
  • The aim of this study was to evaluate the effects of neoadjuvant radiochemotherapy on pathological staging and prognosis in the patients with locally advanced esophageal squamous cell carcinoma.
  • Between January 1991 and December 2000, 473 patients with advanced esophageal carcinoma diagnosed by endoscopic biopsy underwent surgical resection in our center.
  • With informed consent, they were randomized into four groups: neoadjuvant chemotherapy, neoadjuvant radiotherapy, neoadjuvant radiochemotherapy, and surgery alone (control group).
  • The preoperative computed tomography staging criteria were the following: Stage I, the tumor limited to the esophageal lumen or the thickness of the esophageal wall varied between 3-5 mm; Stage II, the thickness exceeds 5 mm but no invasion to the mediastinum or distant metastasis; Stage III, the tumor invades adjacent mediastinal structure; and Stage IV, there is distant metastasis.
  • The tumor resection rate, pathological stage, treatment-related complication, and survival among groups were compared.
  • Their pathological stage after esophagectomy was regressed significantly than that of the control group (50.85%, 55.08% vs. 0%, P < 0.05).
  • The adjuvant chemotherapy group did show significant improvement on resection rate and pathological staging compared with the control group.
  • The treatment-related complication in the three neoadjuvant groups had no significant difference from that of the control group (P > 0.05).
  • Rational application of neoadjuvant radiochemotherapy seems to provide a modest benefit in radical resection and survival in patients with locally advanced esophageal carcinoma.

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  • (PMID = 19703071.001).
  • [ISSN] 1442-2050
  • [Journal-full-title] Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
  • [ISO-abbreviation] Dis. Esophagus
  • [Language] ENG
  • [Publication-type] Journal Article; Randomized Controlled Trial
  • [Publication-country] United States
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17. Toita T, Ogawa K, Adachi G, Kakinohana Y, Nishikuramori Y, Iraha S, Utsunomiya T, Murayama S: Concurrent chemoradiotherapy for squamous cell carcinoma of thoracic esophagus: feasibility and outcome of large regional field and high-dose external beam boost irradiation. Jpn J Clin Oncol; 2001 Aug;31(8):375-81
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  • [Title] Concurrent chemoradiotherapy for squamous cell carcinoma of thoracic esophagus: feasibility and outcome of large regional field and high-dose external beam boost irradiation.
  • OBJECTIVE: To assess the feasibility and outcome of concurrent chemoradiotherapy (CT-RT) with large regional field and high-dose external beam boost irradiation in thoracic esophageal cancer.
  • METHODS: Patients with clinical stage T1 (submucosal)-4N0-1M0 (UICC 1997) squamous cell carcinoma of the thoracic esophagus were eligible.
  • Radiotherapy consisted of regional irradiation (extending from supraclavicular fossa to the paracardial area) with 39.6 Gy followed by high-dose external beam boost up to 66.6 Gy (1.8 Gy/day, five times per week).
  • RESULTS: Thirty patients (stage I, 3; stage II, 11; stage III, 16) were entered into the study.
  • Twenty-one patients (70%) completed the planned treatment.
  • The median survival time was 21 months.
  • The incidence of esophageal stricture (grade 1-2: RTOG) was 21%.
  • CONCLUSIONS: Despite poor compliance for elderly patients and frequent severe toxicities, our concurrent CT-RT resulted in a favorable outcome in thoracic esophageal cancer.
  • [MeSH-major] Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Feasibility Studies. Female. Humans. Male. Middle Aged. Radiotherapy Dosage. Radiotherapy, High-Energy. Survival Rate

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  • (PMID = 11574630.001).
  • [ISSN] 0368-2811
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
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18. 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.
  • 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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19. Zhang MY, Wang Z, Liu XY, Chen G, Liu FY: [The local control of radiotherapy following Ivor-Lewis esophagectomy in the patients with stage II A middle-third thoracic esophageal cancer]. Zhonghua Wai Ke Za Zhi; 2008 Jul 15;46(14):1048-50
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  • [Title] [The local control of radiotherapy following Ivor-Lewis esophagectomy in the patients with stage II A middle-third thoracic esophageal cancer].
  • OBJECTIVE: To investigate the local control of radiotherapy following Ivor-Lewis esophagectomy in the patients with stage IIA middle-third thoracic esophageal cancer.
  • METHODS: From June 1999 to June 2002, 125 patients with stage IIA squamous cell carcinoma of the middle-third thoracic esophagus were treated with Ivor-Lewis esophagectomy with two-fields lymphadenectomy.
  • Of all cases of recurrence, 38 patients (30.4%) developed locoregional recurrence (including 5 patients with locoregional and hematogenous recurrence simultaneously).
  • The locoregional recurrence rate of patients who received postoperative radiotherapy (20.3%) was significantly lower than that of both the group who received adjunctive chemotherapy (40.6%) and the group without adjunctive therapy (41.4%) (P < 0.05).
  • Radiotherapy following Ivor-Lewis esophagectomy is an effective strategy to control local recurrence of the stage II A middle-third thoracic esophageal cancer.
  • [MeSH-major] Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / surgery. Esophagectomy / methods. Radiotherapy, Adjuvant
  • [MeSH-minor] Adult. Aged. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / prevention & control. Neoplasm Staging. Retrospective Studies. Survival Analysis

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  • (PMID = 19094527.001).
  • [ISSN] 0529-5815
  • [Journal-full-title] Zhonghua wai ke za zhi [Chinese journal of surgery]
  • [ISO-abbreviation] Zhonghua Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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20. Suntharalingam M, Moughan J, Coia LR, Krasna MJ, Kachnic L, Haller DG, Willett CG, John MJ, Minsky BD, Owen JB, 1996-1999 Patterns of Care Study: The national practice for patients receiving radiation therapy for carcinoma of the esophagus: results of the 1996-1999 Patterns of Care Study. Int J Radiat Oncol Biol Phys; 2003 Jul 15;56(4):981-7
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  • [Title] The national practice for patients receiving radiation therapy for carcinoma of the esophagus: results of the 1996-1999 Patterns of Care Study.
  • PURPOSE: A Patterns of Care Study (PCS) was conducted to evaluate the standards of practice for patients receiving radiation therapy for esophageal cancer from 1996 to 1999.
  • This study examined the evaluation and treatment schemes used during this time and compared these results to the PCS data obtained between 1992 and 1994 to identify any fundamental changes in national practice.
  • METHODS: A national survey was conducted using a two-stage cluster sampling technique.
  • Specific information was collected on 414 patients with esophageal cancer who received radiotherapy (RT) as part of definitive or adjuvant management at 59 institutions.
  • 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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21. 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.
  • Patients were staged according to a modified 1983 American Joint Committee on Cancer staging system.
  • 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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22. 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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23. 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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24. Liao Z, Zhang Z, Jin J, Ajani JA, Swisher SG, Stevens CW, Ho L, Smythe R, Vaporciyan AA, Putnam JB Jr, Walsh GL, Roth JA, Yao JC, Allen PK, Cox JD, Komaki R: Esophagectomy after concurrent chemoradiotherapy improves locoregional control in clinical stage II or III esophageal cancer patients. Int J Radiat Oncol Biol Phys; 2004 Dec 1;60(5):1484-93
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  • [Title] Esophagectomy after concurrent chemoradiotherapy improves locoregional control in clinical stage II or III esophageal cancer patients.
  • PURPOSE: To evaluate the effect of surgical resection on the outcome of patients with clinical Stage II or III cancer of the esophagus treated with concurrent chemoradiotherapy.
  • METHODS AND MATERIALS: A retrospective review of 132 consecutive patients with clinical Stage II or III esophageal cancer treated with concurrent chemoradiotherapy between January 1990 and December 1998 was performed.
  • The median radiation dose was 50 Gy (range, 30-64.8 Gy) in the definitive chemoradiation group and 45 Gy (range, 30-50.4 Gy) in the chemoradiation plus esophagectomy group.
  • Patients who underwent definitive chemoradiotherapy were older (p = 0.0004) and more likely to have squamous cell carcinoma than adenocarcinoma (p <0.000), upper thoracic or cervical esophageal tumors (p <0.000), and T4 tumors (p = 0.024).
  • Patients treated with chemoradiation plus esophagectomy had statistically significant superior 5-year loco-regional control (67.1% vs. 22.1%, p <0.000), disease-free survival (40.7% vs. 9.9%, p < 0.000), and 5-year overall survival (52.6% vs. 6.5%, p < 0.000) rates and median survival time (62 vs. 12 months) compared with patients treated with chemoradiotherapy only.
  • CONCLUSIONS: Locoregional control was better in clinical Stage II or III esophageal cancer patients treated with concurrent chemoradiation plus esophagectomy.
  • The results from this study suggest the need for a randomized trial to compare chemoradiation with or without esophagectomy in the treatment of cancer of the esophagus.
  • [MeSH-major] Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / surgery. Esophagectomy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / pathology. Adenocarcinoma / radiotherapy. Adenocarcinoma / surgery. Adult. Aged. Aged, 80 and over. Analysis of Variance. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neoplasm Staging. Radiotherapy Dosage. Retrospective Studies. Treatment Failure

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  • (PMID = 15590179.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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25. 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).
  • 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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26. 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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27. 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
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  • [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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28. Cho SH, Shim HJ, Lee SR, Ahn JS, Yang DH, Kim YK, Nam TK, Lee JJ, Kim HJ, Chung IJ: Concurrent chemoradiotherapy with S-1 and cisplatin in advanced esophageal cancer. Dis Esophagus; 2008;21(8):697-703
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  • [Title] Concurrent chemoradiotherapy with S-1 and cisplatin in advanced esophageal cancer.
  • How best to manage advanced esophageal cancer remains unresolved, especially in palliative care.
  • Here, in a pilot study, we evaluated the efficacy and safety of concurrent chemoradiotherapy with S-1 and cisplatin in advanced esophageal cancer.
  • Patients with locally advanced or metastatic squamous cell carcinoma of the esophagus received S-1 and cisplatin at doses of 70 mg/m(2)/day for 14 days and 70 mg/m(2) on day 1, respectively, every 3 weeks.
  • After concurrent chemoradiotherapy, additive chemotherapy was repeated up to six cycles.
  • In patients with stage II or III esophageal cancer, the median progression-free survival and overall survival were 10.6 +/- 0.6 months (95% CI: 9.4-11.8) and 23.0 +/- 5.1 months (95% CI: 13.0-32.9), respectively.
  • In patients with stage IV esophageal cancer, the median progression-free survival and overall survival were 5.4 +/- 1.6 months (95% CI: 2.2-8.6) and 11.6 +/- 1.6 months (95% CI: 8.4-14.8), respectively.
  • The major non-hematological toxicities were asthenia and vomiting, mostly of grades 1 and 2.
  • Thus, concurrent chemoradiotherapy with S-1 and cisplatin may be a promising nonsurgical treatment in advanced esophageal cancer.

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  • (PMID = 18522639.001).
  • [ISSN] 1442-2050
  • [Journal-full-title] Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
  • [ISO-abbreviation] Dis. Esophagus
  • [Language] ENG
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Drug Combinations; 150863-82-4 / S 1 (combination); 1548R74NSZ / Tegafur; 5VT6420TIG / Oxonic Acid; Q20Q21Q62J / Cisplatin
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29. 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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30. Takemura M, Osugi H, Lee S, Kaneko M, Tanaka Y, Fujiwara Y, Nishizawa S, Iwasaki H, Higashino M: [A resected case of thoracic esophageal cancer in which pCR was obtained using low-dose of nedaplatin (CDGP)/5-FU and radiotherapy]. Gan To Kagaku Ryoho; 2004 Sep;31(9):1399-402
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  • [Title] [A resected case of thoracic esophageal cancer in which pCR was obtained using low-dose of nedaplatin (CDGP)/5-FU and radiotherapy].
  • This is a report of a case with esophageal cancer in which pathological CR was obtained by neoadjvant chemoradiotherapy using a low-dose of nedaplatin (CDGP)/5-FU.
  • A protuberant lesion diagnosed as esophageal cancer was found in the middle thoracic esophagus by esophagography.
  • Since another lesion in the upper thoracic esophagus was revealed by endoscopy, metastasis to the cervical lymph nodes was diagnosed by ultrasonography, and preoperative chemoradiotherapy combining a low dose of CDGP/5-FU with radiotherapy was performed.
  • As side effects of this treatment, grade 2 stomatitis and granulocytopenia were observed.
  • The main lesion of the esophagus was found to have significantly diminished through endoscopy after completion of the treatment, and with no malignant cells obtained by biopsy.
  • It was diagnosed as partial response (PR) through imaging diagnosis.
  • Radical resection of esophageal cancer under right thoracotomy and laparotomy was performed.
  • Operative findings were Ch x R-T3N0M0 Stage II R0 D2 Cur A.
  • Pathological examination of resected specimens revealed no viable cancer cells in the esophagus or metastasis to the dissected lymph nodes.
  • Neoadjuvant chemoradiotherapy using a low-dose of CDGP/5-FU is an effective treatment for esophageal cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Combined Modality Therapy. Dose-Response Relationship, Drug. Drug Administration Schedule. Esophagectomy. Fluorouracil / administration & dosage. Humans. Male. Organoplatinum Compounds / administration & dosage. Remission Induction

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  • (PMID = 15446565.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Organoplatinum Compounds; 8UQ3W6JXAN / nedaplatin; U3P01618RT / Fluorouracil
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31. 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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32. D'Angelillo RM, Trodella L, Ramella S, Cellini N, Balducci M, Mantini G, Cellini F, Ciresa M, Fiore M, Evoli A, Sterzi S, Russo P, Grozio A, Cesario A, Granone P: Novel prognostic groups in thymic epithelial tumors: assessment of risk and therapeutic strategy selection. Int J Radiat Oncol Biol Phys; 2008 Jun 1;71(2):420-7
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  • [Title] Novel prognostic groups in thymic epithelial tumors: assessment of risk and therapeutic strategy selection.
  • PURPOSE: To assess the role of multimodality treatment on patients with thymic epithelial tumors (TETs) (i.e., thymomas and thymic squamous cell carcinoma) and to define the prognostic classes according to the Masaoka and World Health Organization histologic classification systems.
  • METHODS AND MATERIALS: Primary surgery was the mainstay of therapy.
  • Adjuvant radiotherapy was given to patients diagnosed with Masaoka Stage II, III, and IVA TET.
  • Adjuvant chemotherapy was administered in selected cases.
  • RESULTS: We reviewed the records of 120 patients with TETs, with a mean follow-up of 13.8 years.
  • Of these 98 patients, Grade 1-2 pulmonary or esophageal toxicity was acute in 12 (12.2%) and late in 8 (8.2%).
  • Three different prognostic classes were defined: favorable, Masaoka Stage I and histologic grade A, AB, B1, B2 or Masaoka Stage II and histologic grade A, AB, B1; unfavorable, Stage IV disease or histologic grade C or Stage III and histologic grade B3; intermediate, all other combinations.
  • Local recurrence, distant recurrence, and tumor-related deaths were also evaluated.
  • CONCLUSION: The analysis of our experience singled out three novel prognostic classes and the assessment of risk identified treatment selection criteria.
  • [MeSH-major] Carcinoma, Squamous Cell / surgery. Thymoma / therapy. Thymus Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Combined Modality Therapy / methods. Esophagus / radiation effects. Female. Humans. Lung / radiation effects. Male. Middle Aged. Myasthenia Gravis / epidemiology. Neoplasm Recurrence, Local. Prognosis. Radiation Injuries / pathology. Radiotherapy, Adjuvant. Retrospective Studies. Risk Assessment. Survival Analysis. World Health Organization

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  • (PMID = 18164843.001).
  • [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] Evaluation Studies; Journal Article
  • [Publication-country] United States
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33. Takemura M, Osugi H, Lee S, Nishikawa T, Fukuhara K, Iwasaki H: [Pathologic complete response of thoracic esophageal cancer developing after gastrectomy to neoadjuvant low-dose nedaplatin (CDGP), 5-fluorouracil and radiotherapy]. Gan To Kagaku Ryoho; 2005 Jul;32(7):1023-7
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  • [Title] [Pathologic complete response of thoracic esophageal cancer developing after gastrectomy to neoadjuvant low-dose nedaplatin (CDGP), 5-fluorouracil and radiotherapy].
  • We treated a 69-year-old man who had developed esophageal cancer following gastrectomy.
  • The cancer located in the middle of the thoracic esophagus, had invaded the trachea and metastasized to cervical lymph nodes according to computed tomography.
  • The esophageal cancer was found by endoscopy to have diminished significantly after completion of neoadjuvant therapy, An endoscopic biopsy specimen was found to contain no malignant cells.
  • Partial response was diagnosed based on imaging, and radical resection of the esophageal cancer was performed via right thoracotomy and laparotomy.
  • Operative staging findings indicated Ch x R-T 3 N 0 M 0, Stage II R 0 D 2 Cur A.
  • Pedicled jejunum was used to reconstruct the esophagus through a mediastinal route.
  • Pathologic examination of resected specimens disclosed no viable cancer cells in the esophagus or metastasis to dissected lymph nodes.
  • Neoadjuvant chemoradiotherapy using low-dose CDGP/5-FU is an effective treatment for esophageal cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy. Gastrectomy
  • [MeSH-minor] Aged. Combined Modality Therapy. Dose-Response Relationship, Drug. Drug Administration Schedule. Fluorouracil / administration & dosage. Humans. Male. Neoadjuvant Therapy. Organoplatinum Compounds / administration & dosage. Remission Induction

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  • (PMID = 16044966.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Organoplatinum Compounds; 8UQ3W6JXAN / nedaplatin; U3P01618RT / Fluorouracil
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34. 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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35. 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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  • [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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36. Sato Y, Takayama T, Sagawa T, Okamoto T, Miyanishi K, Sato T, Araki H, Iyama S, Abe S, Murase K, Takimoto R, Nagakura H, Hareyama M, Kato J, Niitsu Y: A phase I/II study of nedaplatin and 5-fluorouracil with concurrent radiotherapy in patients with esophageal cancer. Cancer Chemother Pharmacol; 2006 Nov;58(5):570-6
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  • [Title] A phase I/II study of nedaplatin and 5-fluorouracil with concurrent radiotherapy in patients with esophageal cancer.
  • PURPOSE: To determine the recommended dose (RD) of cis-diammine-glycolatoplatinum (nedaplatin) when given concurrently with 5-FU and high dose radiation therapy in the treatment of esophageal cancer.
  • The purpose of the phase II trial is to determine efficacy and further define the side effect profile.
  • METHODS: Twenty-six patients with clinical stage I to IVA squamous cell carcinoma of the esophagus were enrolled in a non-surgical treatment comprised of a fixed dose of fluorouracil (400 mg/m2 administered as continuous intravenous infusion on days 1-5 and days 8-12) plus escalating doses of nedaplatin (40 mg/m2 in level 1, 50 mg/m2 in level 2, or 60 mg/m2 in level 3 on days 1 and 8), repeated twice every 3 weeks with concurrent radiotherapy (60 Gy).
  • The 1- and 3-year survival rates were 65.1 and 37.2%, respectively, with a median survival time of 21.2 months.
  • CONCLUSIONS: The combination of nedaplatin and 5-FU with radiation is a feasible regimen that shows promising antitumor activity with an acceptable safety profile in patients with esophageal cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Esophageal Neoplasms / therapy. Radiotherapy, Adjuvant / methods
  • [MeSH-minor] Aged. Anemia / chemically induced. Dose-Response Relationship, Drug. Esophagitis / chemically induced. Female. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Humans. Infusions, Intravenous. Male. Middle Aged. Nausea / chemically induced. Neutropenia / chemically induced. Organoplatinum Compounds / administration & dosage. Organoplatinum Compounds / adverse effects. Remission Induction. Severity of Illness Index. Survival Rate. Thrombocytopenia / chemically induced. Treatment Outcome

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  • (PMID = 16463059.001).
  • [ISSN] 0344-5704
  • [Journal-full-title] Cancer chemotherapy and pharmacology
  • [ISO-abbreviation] Cancer Chemother. Pharmacol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Organoplatinum Compounds; 8UQ3W6JXAN / nedaplatin; U3P01618RT / Fluorouracil
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37. 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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38. 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.
  • METHODS: All patients undergoing esophagectomy by a single surgeon for cancer or high-grade dysplasia between 05/91-05/06 were prospectively entered into an IRB-approved database.
  • 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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39. Swisher SG, Pisters PW, Komaki R, Lahoti S, Ajani JA: Gastroesophageal junction adenocarcinoma. Curr Treat Options Oncol; 2000 Dec;1(5):387-98
MedlinePlus Health Information. consumer health - Esophageal Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The incidence rate of adenocarcinoma of the esophagogastric junction (AEG) is increasing in association with the epidemiologic rise in distal esophageal adenocarcinoma and gastric cardial (AEG type III) tumors.
  • The overall survival rate is poor in most patients with AEG because lymph node or visceral metastases are frequently present at the time patients become symptomatic.
  • A few patients are identified early in the disease because of screening for gastroesophageal reflux and Barrett's esophagus.
  • Early stage AEG (T1N0 or T2NO, carcinoma in situ, or severe dysplasia ) can in many instances be cured with surgery alone.
  • Ablative treatments for early stage AEG, including endoscopic fulguration by cautery and laser or photodynamic therapy, are investigational at this time.
  • Locoregionally advanced AEG (T3, T4, N1, or M1a ) without distant systemic metastases (M1b) has a poor overall survival rate with surgery alone or definitive chemotherapy and radiation therapy without surgery.
  • Analysis of the use of multimodality treatment strategies for locoregionally advanced AEG types I and II have demonstrated improved survival rates in two small phase III trials with preoperative concurrent chemoradiotherapy followed by surgical resection.
  • In contrast, three small phase III trials with preoperative concurrent or sequential chemoradiotherapy in patients with predominantly squamous cell carcinoma did not demonstrate any clear survival advantage.
  • Additionally, a randomized phase III study evaluating preoperative chemotherapy without radiation therapy in esophageal cancer (predominantly adenocarcinoma) has demonstrated no survival benefit.
  • 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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