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1. Keresztes RS, Port JL, Pasmantier MW, Korst RJ, Altorki NK: Preoperative chemotherapy for esophageal cancer with paclitaxel and carboplatin: results of a phase II trial. J Thorac Cardiovasc Surg; 2003 Nov;126(5):1603-8
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  • [Title] Preoperative chemotherapy for esophageal cancer with paclitaxel and carboplatin: results of a phase II trial.
  • OBJECTIVE: Paclitaxel has one of the highest response rates when used as a single agent in patients with esophageal cancer.
  • The combination of paclitaxel and carboplatin has been shown to be a well-tolerated and safe regimen in non-small cell lung cancer.
  • The objective of this study was to determine the efficacy of preoperative paclitaxel and carboplatin in patients with carcinoma of the esophagus.
  • Patients 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. Machlenkin S, Melzer E, Idelevich E, Ziv-Sokolovsky N, Klein Y, Kashtan H: Endoscopic ultrasound: doubtful accuracy for restaging esophageal cancer after preoperative chemotherapy. Isr Med Assoc J; 2009 Mar;11(3):166-9
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  • [Title] Endoscopic ultrasound: doubtful accuracy for restaging esophageal cancer after preoperative chemotherapy.
  • BACKGROUND: The role of endoscopic ultrasound in evaluating the response of esophageal cancer to neoadjuvant chemotherapy is controversial.
  • METHODS: The disease stage of patients with esophageal cancer was established by means of the TNM classification system.
  • The initial staging was determined by chest and abdominal computed tomography and EUS.
  • Upon completion of the chemotherapy, patients were restaged and then underwent esophagectomy.
  • RESULTS: NAC was conducted in 20 patients with initial stage IIB and III carcinoma of the esophagus (study group).
  • Post-chemotherapy EUS accurately predicted the surgical pathology stage in 6 patients (30%).
  • The accuracy of EUS in determining the T status alone was 80%.
  • Thirteen patients with initial stage I-IIA underwent primary esophagectomy after the initial staging (control group).
  • EUS accurately predicted the surgical pathology disease stage in 11 patients (85%).
  • CONCLUSIONS: EUS is an accurate modality for initial staging of esophageal carcinoma.
  • However, it is not a reliable tool for restaging esophageal cancer after NAC and it cannot predict response to chemotherapy.
  • [MeSH-major] Endosonography. Esophageal Neoplasms / pathology. Esophageal Neoplasms / ultrasonography
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Esophagectomy. Female. Humans. Male. Middle Aged. Neoadjuvant Therapy. Neoplasm Staging / methods. Postoperative Period. Reproducibility of Results. Retrospective Studies

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  • (PMID = 19544707.001).
  • [ISSN] 1565-1088
  • [Journal-full-title] The Israel Medical Association journal : IMAJ
  • [ISO-abbreviation] Isr. Med. Assoc. J.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Israel
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3. Mariette C, Piessen G, Triboulet JP: [Is there still a role for surgery in esophageal carcinoma in 2007?]. Bull Cancer; 2007 Jan;94(1):63-9
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  • [Title] [Is there still a role for surgery in esophageal carcinoma in 2007?].
  • Regarding curative treatment of oesophageal carcinoma, many therapeutic options could be planned.
  • Surgery is traditionally considered as the most appropriate treatment for locoregional control and long-term survival.
  • Because of the poor prognosis, muldisciplinary approach is necessary, including surgery, radiotherapy and chemotherapy, alone or in association.
  • However, because of the small number of well randomised trials, the question of which treatment is the most appropriate is still under debate.
  • In 2007, following therapeutic strategies could be drawn: surgery is the main treatment, used alone for stages I and IIa, in association with neoadjuvant chemotherapy (CT) or chemoradiation (CRT) for stages IIb.
  • For locally advanced tumours (stage III), adenocarcinomas required neoadjuvant CT or CRT followed by surgery, whereas for squamous cell carcinomas exclusive CRT is the main treatment with following important conditions : (i) response to CRT, (ii) curative salvage surgery in case of non response after 2 cycles or persistent tumour after 4 cycles, (iii) long-term survival may be probably enhanced by adjuvant surgery in experienced centres for selected patients.
  • [MeSH-major] Esophageal Neoplasms / surgery
  • [MeSH-minor] Chemotherapy, Adjuvant. Humans. Neoadjuvant Therapy / methods. Neoplasm Staging. Radiotherapy, Adjuvant. Randomized Controlled Trials as Topic

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  • (PMID = 17237006.001).
  • [ISSN] 1769-6917
  • [Journal-full-title] Bulletin du cancer
  • [ISO-abbreviation] Bull Cancer
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Number-of-references] 46
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4. Elorza-Orúe JL, Larburu-Etxaniz S, Asensio-Gallego JI, Enríquez-Navascués JM, Echenique-Elizondo M: [Minimally invasive esophagectomy]. Cir Esp; 2006 Sep;80(3):151-6
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  • INTRODUCTION: Currently, the bases for the treatment of esophageal cancer are surgical resection and chemotherapy.
  • We present the results of our initial experience with this technique in the treatment of esophageal cancer.
  • MATERIAL AND METHOD: Fourteen patients with a diagnosis of esophageal cancer were selected to undergo MIE in three stages: right thoracoscopy, laparoscopy, and left cervicotomy with cervical esophagogastric anastomosis.
  • Histological diagnosis was epidermoid carcinoma (n = 11) and high grade dysplasia (n = 3), one of which was highly suspicious of malignant transformation.
  • After extension studies, preoperative clinical stages were as follows: stage 0 (n = 3), stage IIA (n = 10), and stage III (n = 1).
  • Seven patients were treated with chemotherapy and neoadjuvant radiotherapy and the remainder underwent surgery without prior treatment.
  • RESULTS: The mean operating time was 299 minutes (range: 195-425).
  • CONCLUSIONS: Although MIE is a demanding technique, we believe that it is technically feasible in the treatment of esophageal cancer with acceptable postoperative morbidity and mortality.
  • [MeSH-major] Esophageal Neoplasms / surgery. Esophagectomy / methods. Laparoscopy. Thoracoscopy

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  • (PMID = 16956550.001).
  • [ISSN] 0009-739X
  • [Journal-full-title] Cirugía española
  • [ISO-abbreviation] Cir Esp
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Spain
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5. Garcia-del-Muro X, Maroto P, Gumà J, Sastre J, López Brea M, Arranz JA, Lainez N, Soto de Prado D, Aparicio J, Piulats JM, Pérez X, Germá-Lluch JR: Chemotherapy as an alternative to radiotherapy in the treatment of stage IIA and IIB testicular seminoma: a Spanish Germ Cell Cancer Group Study. J Clin Oncol; 2008 Nov 20;26(33):5416-21
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  • [Title] Chemotherapy as an alternative to radiotherapy in the treatment of stage IIA and IIB testicular seminoma: a Spanish Germ Cell Cancer Group Study.
  • PURPOSE: To assess the long-term efficacy and toxicity of front-line cisplatin-based chemotherapy in patients with stage IIA or IIB testicular seminoma.
  • PATIENTS AND METHODS: Untreated patients with pure seminoma of the testis after orchiectomy, with clinical stage IIA or IIB, were considered eligible for this prospective observational study.
  • Chemotherapy consisted of either four cycles of cisplatin and etoposide or three cycles of cisplatin, etoposide, and bleomycin.
  • Eighteen patients had stage IIA disease, and 54 patients had stage IIB disease.
  • After a median follow-up time of 71.5 months, six patients with stage IIB disease experienced relapse, and one of these patients died as a result of seminoma.
  • Three patients experienced non-seminoma-related deaths (two died from a further esophageal carcinoma, and one died from an upper digestive hemorrhage).
  • The estimated 5-year progression-free survival rates for patients with stage IIA or IIB disease were 100% and 87% (95% CI, 77.5% to 97%), respectively.
  • CONCLUSION: Chemotherapy is a highly effective and well-tolerated treatment for patients with stage IIA or IIB seminoma and represents an available alternative that could avoid some of the serious late effects associated with radiotherapy.
  • Further studies focusing on long-term toxicities of different treatment modalities are needed.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Seminoma / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Bleomycin / administration & dosage. Cisplatin / administration & dosage. Combined Modality Therapy. Etoposide / administration & dosage. Humans. Male. Middle Aged. Survival Rate. Young Adult

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  • [CommentIn] J Clin Oncol. 2009 Apr 20;27(12):2101-2; author reply 2102-3 [19289608.001]
  • (PMID = 18936476.001).
  • [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; Multicenter Study
  • [Publication-country] United States
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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6. Tomasich FD, Valladares GC, Demarchi VC, Gagliardi D: [Influence of neoadjuvant treatment on morbidity-mortality of esophagectomies]. Rev Assoc Med Bras (1992); 2003 Jul-Sep;49(3):300-5
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  • [Title] [Influence of neoadjuvant treatment on morbidity-mortality of esophagectomies].
  • [Transliterated title] Influência do tratamento neoadjuvante na morbi-mortalidade das esofagectomias.
  • BACKGROUND: To evaluate the influence of neoadjuvant treatment (chemotherapy and/or radiotherapy) on postoperative complications and hospital lethality in patients with esophageal cancer submitted to esophagectomy with two-field lymphadenectomy.
  • METHODS: Retrospective study of 132 patients with esophageal cancer admitted in Department of Surgery in Erasto Gaertner Hospital, from January 1987 to January 1998, divided according to realization of neoadjuvant treatment or not.
  • Variables related to patient (sex, age, general condition, ponderal loss, co-morbidities, tabagism), to tumor (histological type, localization, staging) and to surgical procedure (type and localization of anastomosis, surgical time, hospitalization time) were noted and related to postoperative complications and mortality.
  • The predominant histological type was squamous cell carcinoma in 94.7% of the cases.
  • Six patients (4.54%) were stage I, 44 (33.33%) IIA, 24 (18.18%) IIB, 38 (28.80%) III and 17 (12.90%) IV.
  • Considering the neoadjuvant treatment, 39 patients (29.54%) were submitted to chemotherapy and 22 (16.67%) to radiotherapy.
  • CONCLUSION: Neoadjuvant chemotherapic and radiotherapeutic treatments were related to superior occurrence of postoperative complications, without influence on hospital lethality.
  • [MeSH-major] Carcinoma, Squamous Cell / therapy. Esophageal Neoplasms / therapy. Esophagectomy. Postoperative Complications / mortality
  • [MeSH-minor] Aged. Brazil / epidemiology. Chemotherapy, Adjuvant. Female. Hospital Mortality. Humans. Lymph Node Excision. Male. Morbidity. Multivariate Analysis. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis

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  • (PMID = 14666356.001).
  • [ISSN] 0104-4230
  • [Journal-full-title] Revista da Associação Médica Brasileira (1992)
  • [ISO-abbreviation] Rev Assoc Med Bras (1992)
  • [Language] por
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Brazil
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7. Hurmuzlu M, Øvrebø K, Monge OR, Smaaland R, Wentzel-Larsen T, Viste A: High-dose chemoradiotherapy followed by surgery versus surgery alone in esophageal cancer: a retrospective cohort study. World J Surg Oncol; 2010;8:46
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  • [Title] High-dose chemoradiotherapy followed by surgery versus surgery alone in esophageal cancer: a retrospective cohort study.
  • BACKGROUND: We aimed to assess whether high-dose preoperative chemoradiotherapy (CRT) improves outcome in esophageal cancer patients compared to surgery alone and to define possible prognostic factors for overall survival.
  • METHODS: Hundred-and-seven patients with disease stage IIA - III were treated with either surgery alone (n = 45) or high-dose preoperative CRT (n = 62).
  • Sixty-seven patients had adenocarcinomas, 39 squamous cell carcinomas and one undifferentiated carcinoma.
  • CRT was given as three intensive chemotherapy courses by cisplatin 100 mg/m2 on day 1 and 5-fluorouracil 1000 mg/m2/day, from day 1 through day 5 as continuous infusion.
  • The last two courses were given concurrent with high-dose radiotherapy, 2 Gy/fraction and a median dose of 66 Gy.
  • CONCLUSION: We found no significant survival advantage in esophageal cancer stage IIA-III following preoperative high-dose CRT compared to surgery alone.
  • [MeSH-major] Adenocarcinoma / therapy. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Carcinoma, Squamous Cell / therapy. Esophageal Neoplasms / therapy. Esophagectomy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cisplatin / administration & dosage. Cohort Studies. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neoplasm Staging. Radiotherapy Dosage. Retrospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 20515502.001).
  • [ISSN] 1477-7819
  • [Journal-full-title] World journal of surgical oncology
  • [ISO-abbreviation] World J Surg Oncol
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
  • [Other-IDs] NLM/ PMC2890519
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8. Wu Z, Ma JY, Yang JJ, Zhao YF, Zhang SF: Primary small cell carcinoma of esophagus: report of 9 cases and review of literature. World J Gastroenterol; 2004 Dec 15;10(24):3680-2
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  • [Title] Primary small cell carcinoma of esophagus: report of 9 cases and review of literature.
  • AIM: To analyze the clinical manifestations, pathological features and treatment of primary small cell carcinoma (SCC) of the esophagus and to review the literature on this entity.
  • METHODS: The records of 9 patients with primary esophageal small cell carcinoma were examined and the demographic data, presenting symptoms, methods of tumor diagnosis, and types of treatment given, response to treatment, pathologic findings, and clinical outcome were reviewed.
  • In 5 cases the tumors were located in the mid-esophagus, 3 cases in the lower third of the esophagus and 1 case in the upper third.
  • The average length of esophageal involvement was 5 cm.
  • They underwent radical resection, regional lymph node clearance and esophageal-stomach anastomosis in thorax or at neck.
  • Two patients had a stage IIa disease, five had a stage IIb disease, and the other two had a stage III disease of International Union Contrele Cancer (UICC).
  • All of them were histologically and immunohistochemically confirmed SCC of esophagus.
  • Three of the nine resected specimens showed foci of squamous cell carcinoma in situ.
  • They received adjuvant systemic chemotherapy and local radiation therapy after discharge.
  • During follow-up, three patients developed multiple liver, brain, lung and bone metastases and died between 5 and 18 mo after the diagnosis.
  • Three patients developed widespread metastasis disease and died between 18 and 37 mo after the diagnosis.
  • CONCLUSION: Primary small cell carcinoma of the esophagus is a rare but very malignant tumor.
  • Radical resection combined with chemotherapy and radiotherapy is helpful in limited stage cases.
  • [MeSH-major] Carcinoma, Small Cell / pathology. Esophageal Neoplasms / pathology

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  • (PMID = 15534932.001).
  • [ISSN] 1007-9327
  • [Journal-full-title] World journal of gastroenterology
  • [ISO-abbreviation] World J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] China
  • [Number-of-references] 18
  • [Other-IDs] NLM/ PMC4612018
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9. Divers SG, Spencer SA, Carey D, Busby EM, Hyatt MD, Robert F: Phase I/IIa study of cisplatin and gemcitabine as induction chemotherapy followed by concurrent chemoradiotherapy with gemcitabine and paclitaxel for locally advanced non-small-cell lung cancer. J Clin Oncol; 2005 Sep 20;23(27):6664-73
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  • [Title] Phase I/IIa study of cisplatin and gemcitabine as induction chemotherapy followed by concurrent chemoradiotherapy with gemcitabine and paclitaxel for locally advanced non-small-cell lung cancer.
  • PURPOSE: This is a phase I/IIa study to assess tolerance of gemcitabine and paclitaxel with radiotherapy in locally advanced non-small-cell lung cancer after induction chemotherapy.
  • PATIENTS AND METHODS: Fifty-seven patients with stage III non-small-cell lung cancer were treated with cisplatin 80 mg/m2 on days 1 and 22 and gemcitabine 1,250 mg/m2 on days 1, 8, 22, and 28.
  • Chemoradiotherapy began on day 43 as follows: cohort 1 (n = 9), gemcitabine 300 mg/m2 and paclitaxel 35 mg/m2 weekly (except week 9); cohort 2 (n = 9), gemcitabine 150 mg/m2 and paclitaxel 35 mg/m2 weekly (except week 9); cohort 3 (n = 10) and the 25 phase IIa patients, gemcitabine 300 mg/m2 and paclitaxel 135 mg/m2 every 21 days.
  • Patients were treated with three-dimensional thoracic radiotherapy concurrently to 60 Gy.
  • RESULTS: Weekly chemotherapy resulted in grade 4 esophageal and grade 3 or higher pulmonary toxicities.
  • Reduction in dose density (cohort 3) led to a tolerable toxicity profile and was chosen as the phase IIa regimen.
  • The response rate after consolidation therapy was 75% (94% for weekly chemotherapy v 82% for every 3 weeks).
  • Dosimetric parameters including V15, V20, V30 (percent lung volume receiving > or = 15, > or = 20, and > or = 30 Gy, respectively), and mean lung dose correlated with pulmonary toxicity.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Non-Small-Cell Lung / pathology. Carcinoma, Non-Small-Cell Lung / therapy. Lung Neoplasms / pathology. Lung Neoplasms / therapy. Neoplasm Invasiveness / pathology
  • [MeSH-minor] Adult. Aged. Cisplatin / therapeutic use. Combined Modality Therapy. Confidence Intervals. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Dose-Response Relationship, Drug. Drug Administration Schedule. Female. Humans. Male. Maximum Tolerated Dose. Middle Aged. Neoplasm Staging. Paclitaxel / therapeutic use. Probability. Radiotherapy, Adjuvant. Remission Induction. Survival Analysis

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  • (PMID = 16170174.001).
  • [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 / P30CA13148
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Clinical Trial, Phase II; Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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10. Yano M, Shiozaki H, Tsujinaka T, Inoue M, Doki Y, Fujiwara Y, Monden M: Squamous cell carcinoma of the esophagus infiltrating the respiratory tract is less sensitive to preoperative concurrent radiation and chemotherapy. J Am Coll Surg; 2000 Dec;191(6):626-34
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  • [Title] Squamous cell carcinoma of the esophagus infiltrating the respiratory tract is less sensitive to preoperative concurrent radiation and chemotherapy.
  • BACKGROUND: The prognosis of upper thoracic esophageal cancer is poor when compared with middle and lower thoracic esophageal cancer because the tumor easily infiltrates the respiratory tract and surgical en-bloc resection is difficult.
  • Recently, preoperative chemoradiation therapy has been shown to lead to down-staging of the disease and improve prognosis.
  • But the benefit of this therapy for tumors infiltrating the respiratory tract remains unknown.
  • STUDY DESIGN: Fifty-six patients with thoracic esophageal cancer infiltrating neighboring organs, but with no hematogeneous metastasis, were given preoperative concurrent chemotherapy (5-fluorouracil and cisplatin) and radiation (40 Gy) therapy.
  • Histologic effectiveness (8.3%, 50.0%, and 41.7% versus 25.0%, 70.0%, and 5.0% in grade 3, grade 2, and grade 1, respectively, for patients with respiratory tract invasion versus those without it, p = 0.0189) and histologic stages (8.3%, 8.3%, 8.3%, 8.3%, 25.0%, and 41.7% versus 20.0%, 0%, 15.0%, 25.0%, 40.0%, and 0% in pathologic CR, stage I, stage IIA, stage IIB, stage III, and stage IV, respectively, for patients with respiratory tract invasion versus those without it, p = 0.0496) were significantly better in patients negative for respiratory tract invasion; the percentages of patients with lymph node metastasis did not differ significantly between the two groups.
  • CONCLUSIONS: Because the prognosis of patients with thoracic esophageal cancer infiltrating the respiratory tract is extremely poor, partially because of the low local effectiveness of preoperative concurrent chemotherapy and radiation therapy, caution is needed when deciding on salvage surgery.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / secondary. Carcinoma, Squamous Cell / therapy. Drug Tolerance. Esophageal Neoplasms / pathology. Esophagectomy. Preoperative Care / methods. Radiation Tolerance. Respiratory Tract Neoplasms / secondary. Respiratory Tract Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Lymph Node Excision. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Recurrence, Local / pathology. Neoplasm Staging. Prognosis. Proportional Hazards Models. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 11129811.001).
  • [ISSN] 1072-7515
  • [Journal-full-title] Journal of the American College of Surgeons
  • [ISO-abbreviation] J. Am. Coll. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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11. McClave SA, Jones WF, Evans WB: Do physician attitudes and practices limit use of EUS in the staging and the treatment of esophageal carcinoma? Gastrointest Endosc; 2005 Jun;61(7):840-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Do physician attitudes and practices limit use of EUS in the staging and the treatment of esophageal carcinoma?
  • BACKGROUND: Although EUS provides superior local staging of esophageal carcinoma when compared with other tests, EUS seems to be underused by physicians.
  • We designed this prospective study to determine whether EUS is ordered in the evaluation of esophageal cancer and whether staging information obtained would change management.
  • METHODS: A total of 114 physicians were mailed a questionnaire that surveyed which tests are used in evaluating patients with esophageal cancer, the order in which they are requested, and their estimated cost.
  • Physicians were asked to estimate prognosis and to indicate which therapy would be used for each specific TNM cancer stage.
  • Only 47.3% of physicians would use EUS in the patient workup for esophageal cancer.
  • A significantly greater number of internists (78.9%, p = 0.055) would not order EUS, and 31.6% of internists would not use any staging data before referral to another physician for definitive management.
  • Physicians were accurate in their assessment of the prognosis for each cancer stage and the cost of each test.
  • There was no difference in the use of surgery between disciplines for stages O, I, IIA, and IV.
  • However, significantly more surgeons than nonsurgeons would use surgery for stage IIB (100.0% vs. 71.3%, p = 0.019), with a trend toward greater use by surgeons for stage III (64.3% vs. 34.1%, p = 0.11).
  • Except for significantly greater use of chemotherapy by surgeons and oncologists for stage IIA than internists and gastroenterologists (36.6% vs. 3.1%, p = 0.0006), there were no differences between subspecialties with use of chemotherapy for all other stages or use of radiation therapy for any stage.
  • CONCLUSIONS: Clinicians have an adequate understanding of patient survival based on cancer stage and a reasonable appreciation of cost for diagnostic tests regarding esophageal carcinoma.
  • Specific data on cancer staging does impact treatment choices and management decisions.
  • EUS is grossly underused by clinicians for staging esophageal cancer.
  • The ultimate modality of treatment may be more related to the type of physician that the patient is referred to, instead of the specific cancer stage.
  • [MeSH-major] Attitude of Health Personnel. Carcinoma / diagnostic imaging. Endosonography / utilization. Esophageal Neoplasms / diagnostic imaging. Physicians. Practice Patterns, Physicians'
  • [MeSH-minor] Adenocarcinoma / pathology. Adenocarcinoma / therapy. Antineoplastic Agents / therapeutic use. Barium Sulfate. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / therapy. Contrast Media. Esophagoscopy. Gastroenterology. General Surgery. Humans. Internal Medicine. Medical Oncology. Neoplasm Staging. Patient Care Planning. Prognosis. Prospective Studies. Radiopharmaceuticals / therapeutic use. Tomography, X-Ray Computed

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  • (PMID = 15933685.001).
  • [ISSN] 0016-5107
  • [Journal-full-title] Gastrointestinal endoscopy
  • [ISO-abbreviation] Gastrointest. Endosc.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Contrast Media; 0 / Radiopharmaceuticals; 25BB7EKE2E / Barium Sulfate
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12. Swanson SJ, Batirel HF, Bueno R, Jaklitsch MT, Lukanich JM, Allred E, Mentzer SJ, Sugarbaker DJ: Transthoracic esophagectomy with radical mediastinal and abdominal lymph node dissection and cervical esophagogastrostomy for esophageal carcinoma. Ann Thorac Surg; 2001 Dec;72(6):1918-24; discussion 1924-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Transthoracic esophagectomy with radical mediastinal and abdominal lymph node dissection and cervical esophagogastrostomy for esophageal carcinoma.
  • BACKGROUND: Several techniques for esophageal resection have been reported.
  • This study examines the morbidity, mortality, and early survival of patients after transthoracic esophagectomy for esophageal carcinoma using current staging techniques and neoadjuvant therapy.
  • METHODS: Three hundred forty-two patients had surgery for esophageal carcinoma between 1989 and 2000 at our institution.
  • Kaplan-Meier curves and univariate and multivariate analyses were performed by postsurgical pathologic stage.
  • Eighty-one percent (202) had induction chemotherapy (all patients with clinical T3/4 or N1).
  • Overall survival at 3 years was 44%; median survival was 25 months, and 3-year survival by posttreatment pathologic stage was: stage 0 (complete response) (n = 60), 56%; stage I (n = 32), 65%; stage IIA (n = 67), 41%; stage IIB (n = 30), 46%; and stage III (n = 49), 17%.
  • Five patients with tumor in situ, 6 patients with stage IV disease, and 1 patient who could not be staged (12 pts) were excluded from survival and multivariate calculations.
  • CONCLUSIONS: Total thoracic esophagectomy with node dissection for esophageal cancer appears to have acceptable morbidity and mortality with encouraging survival results in the setting of neoadjuvant therapy.
  • [MeSH-major] Adenocarcinoma / surgery. Barrett Esophagus / surgery. Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / surgery. Esophagectomy / methods. Gastrostomy / methods. Lymph Node Excision / methods. Precancerous Conditions / surgery

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  • (PMID = 11789772.001).
  • [ISSN] 0003-4975
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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13. Javle MM, Nwogu CE, Donohue KA, Iyer RV, Brady WE, Khemka SV, Smith JL, Demmy TL, Yang GY, Nava HR: Management of locoregional stage esophageal cancer: a single center experience. Dis Esophagus; 2006;19(2):78-83
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  • [Title] Management of locoregional stage esophageal cancer: a single center experience.
  • Therapeutic options for locoregional esophageal cancer (EC) include primary surgery, neoadjuvant or definitive chemoradiation and systemic chemotherapy.
  • The role of surgery in these multimodal strategies has recently been debated and definitive chemoradiation is being offered as an alternative to surgery at many centers.
  • We examined our results with multimodal therapy and surgery in this patient population.
  • We conducted a retrospective analysis of 172 patients with locoregional (AJCC stages I-III) EC treated at RPCI between February 14, 1990 and September 20, 2002.
  • There were 100 regional (stages IIB-III), 69 local (stages I-IIA) and three in situ cases.
  • Initial therapy was either combined modality (n = 122) or single modality (surgery) (n = 50).
  • Median survival for all patients was 25.3 months and was better for local stage with surgery alone (75 months) than with neoadjuvant (35.7 months) or definitive chemoradiation (19.1 months, P < 0.001).
  • Survival for patients with regional disease treated with surgery alone, neoadjuvant or definitive chemoradiation was 21.5, 24.4 and 11.8 months, respectively (P = not significant).
  • On multivariate analysis, carefully selected patients treated with surgery alone had better outcomes compared with those treated with definitive chemoradiation (P < 0.001).
  • Patients with locoregional esophageal cancer who are eligible for surgical resection either alone or as a part of multimodal therapy may have better outcomes than those treated with non-surgical approaches.

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  • (PMID = 16643174.001).
  • [ISSN] 1120-8694
  • [Journal-full-title] Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
  • [ISO-abbreviation] Dis. Esophagus
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] United States
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14. Zhang MY, Wang Z, Liu XY, Chen G, Liu FY: [The local control of radiotherapy following Ivor-Lewis esophagectomy in the patients with stage II A middle-third thoracic esophageal cancer]. Zhonghua Wai Ke Za Zhi; 2008 Jul 15;46(14):1048-50
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  • [Title] [The local control of radiotherapy following Ivor-Lewis esophagectomy in the patients with stage II A middle-third thoracic esophageal cancer].
  • OBJECTIVE: To investigate the local control of radiotherapy following Ivor-Lewis esophagectomy in the patients with stage IIA middle-third thoracic esophageal cancer.
  • METHODS: From June 1999 to June 2002, 125 patients with stage IIA squamous cell carcinoma of the middle-third thoracic esophagus were treated with Ivor-Lewis esophagectomy with two-fields lymphadenectomy.
  • Of all cases of recurrence, 38 patients (30.4%) developed locoregional recurrence (including 5 patients with locoregional and hematogenous recurrence simultaneously).
  • The locoregional recurrence rate of patients who received postoperative radiotherapy (20.3%) was significantly lower than that of both the group who received adjunctive chemotherapy (40.6%) and the group without adjunctive therapy (41.4%) (P < 0.05).
  • Radiotherapy following Ivor-Lewis esophagectomy is an effective strategy to control local recurrence of the stage II A middle-third thoracic esophageal cancer.
  • [MeSH-major] Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / surgery. Esophagectomy / methods. Radiotherapy, Adjuvant

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  • (PMID = 19094527.001).
  • [ISSN] 0529-5815
  • [Journal-full-title] Zhonghua wai ke za zhi [Chinese journal of surgery]
  • [ISO-abbreviation] Zhonghua Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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15. Visbal AL, Allen MS, Miller DL, Deschamps C, Trastek VF, Pairolero PC: Ivor Lewis esophagogastrectomy for esophageal cancer. Ann Thorac Surg; 2001 Jun;71(6):1803-8
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  • [Title] Ivor Lewis esophagogastrectomy for esophageal cancer.
  • BACKGROUND: To examine the efficacy of the Ivor Lewis esophagogastrectomy for esophageal carcinoma prior to the widespread use of preoperative chemotherapy and irradiation, we reviewed our experience.
  • METHODS: We reexamined the cases of 220 consecutive patients who underwent an Ivor Lewis esophagogastrectomy for esophageal cancer from January 1992 through December 1995.
  • The results of pathological study showed adenocarcinoma in 188 patients (85.5%), squamous cell carcinoma in 31 (14.1%), and leiomyosarcoma in 1 patient (0.5%).
  • Postsurgical staging was as follows: stage 0 in 10 patients, stage I in 19, stage IIa in 38, stage IIb in 28, stage III in 111, and stage IV in 14.
  • The overall 5-year survival rate was 25.2%; it was 80% for patients in stage 0, 94.4% for those in stage I, 36.0% for those in stage IIa, 14.3% for patients in stage IIb, 10% for those in stage III and 0% for patients in stage IV.
  • CONCLUSIONS: Ivor Lewis esophagogastrectomy for esophageal cancer is a safe operation.
  • Long-term survival is stage dependent.
  • The low survival associated with advanced cancers should stimulate the search for effective neoadjuvant therapy.
  • [MeSH-major] Adenocarcinoma / surgery. Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / surgery. Esophagectomy / methods. Gastrectomy / methods

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  • (PMID = 11426751.001).
  • [ISSN] 0003-4975
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Hurmuzlu M, Monge OR, Smaaland R, Viste A: High-dose definitive concomitant chemoradiotherapy in non-metastatic locally advanced esophageal cancer: toxicity and outcome. Dis Esophagus; 2010 Apr;23(3):244-52
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  • [Title] High-dose definitive concomitant chemoradiotherapy in non-metastatic locally advanced esophageal cancer: toxicity and outcome.
  • This study is a retrospective analysis of high-dose definitive concomitant chemoradiotherapy in locally advanced esophageal cancer in a single institution.
  • The aim of the study was to identify and quantify the toxicity associated with the high-dose treatment and to analyze the outcome of this treatment.
  • Forty-six patients (41 men and 5 women, median age of 67.5 years) with disease stage IIA-III esophageal cancer were treated with high-dose definitive chemoradiotherapy.
  • The patients were treated with three courses of chemotherapy.
  • Each chemotherapy course consisted of cisplatin 100 mg/m(2), day 1 and 5-Fluorouracil 1000 mg/m(2)/day, day 1-5.
  • Concurrent radiotherapy (66 Gy/33 fractions) was administered during the last two courses of chemotherapy.
  • Treatment related mortality occurred in one patient (2.5%) due to neutropenic septicemia.
  • Follow-up time for surviving patients (2/46) was 45 and 112 months.
  • For the entire study population, the median time to local recurrence in the radiotherapy field was 33 months and the median time to distant metastasis was 8.7 months, whereas median overall survival was 10.8 months and median disease-specific survival 11 months.
  • For responders to chemoradiotherapy, the median time to local recurrence was 76 months, the median time to distant metastasis 16.8 months, the median overall survival and the median disease-specific survival for the responders were both 17 months.
  • By multivariate analysis response to chemoradiotherapy and lower disease stage were positive prognostic factors for survival.
  • The results of our study have shown that concurrent high-dose chemoradiotherapy provides long-term local tumor control in locally advanced esophageal cancer.
  • However, toxicities following this high-dose treatment, while manageable, were significant.
  • Survival rates were not improved by high-dose chemoradiotherapy compared with what is reported in previous studies applying lower doses of definitive chemoradiotherapy.

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  • (PMID = 19664075.001).
  • [ISSN] 1442-2050
  • [Journal-full-title] Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
  • [ISO-abbreviation] Dis. Esophagus
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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17. Kang CH, Kim YT, Jeon SH, Sung SW, Kim JH: Lymphadenectomy extent is closely related to long-term survival in esophageal cancer. Eur J Cardiothorac Surg; 2007 Feb;31(2):154-60
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  • [Title] Lymphadenectomy extent is closely related to long-term survival in esophageal cancer.
  • OBJECTIVE: The optimal extent of lymphadenectomy during esophagectomy for esophageal cancer remains debatable.
  • The aim of this study was to identify the effect of the extent of lymphadenectomy on survival and recurrence after esophagectomy in esophageal cancer.
  • MATERIALS AND METHODS: Two hundred thirty-three patients who were operated on between January 1995 and December 2003 due to esophageal cancer were included.
  • The study subjects were stage I, II, and III esophageal squamous cell carcinoma patients who had undergone curative resection without neoadjuvant chemotherapy or chemoradiation therapy.
  • RESULTS: The pathologic stages were stage I in 57 (24.5%), IIA in 69 (29.6%), IIB in 27 (11.6%), and III in 80 (34.3%).
  • CONCLUSIONS: A wider extent of lymphadenectomy in esophageal cancer was associated with better long-term survival than limited lymphadenectomy, especially in N0 patients.
  • [MeSH-major] Carcinoma, Squamous Cell / secondary. Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / surgery. Lymph Node Excision / methods

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  • (PMID = 17145185.001).
  • [ISSN] 1010-7940
  • [Journal-full-title] European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • [ISO-abbreviation] Eur J Cardiothorac Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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18. Kenjo M, Uno T, Murakami Y, Nagata Y, Oguchi M, Saito S, Numasaki H, Teshima T, Mitsumori M: Radiation therapy for esophageal cancer in Japan: results of the Patterns of Care Study 1999-2001. Int J Radiat Oncol Biol Phys; 2009 Oct 1;75(2):357-63
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  • [Title] Radiation therapy for esophageal cancer in Japan: results of the Patterns of Care Study 1999-2001.
  • PURPOSE: To describe patient characteristics and the process of radiotherapy (RT) for patients with esophageal cancer treated between 1999 and 2001 in Japan.
  • Detailed information was accumulated on 621 patients with thoracic esophageal cancer who received RT.
  • Ninety-nine percent had squamous cell carcinoma histology.
  • Fifty-five percent had the main lesion in the middle thoracic esophagus.
  • Fourteen percent had clinical Stage 0-I disease, 32% had Stage IIA-IIB, 43% had Stage III, and 10% had Stage IV disease.
  • Chemotherapy was given to 63% of patients; 39% received definitive chemoradiotherapy (CRT) without surgery and 24% pre- or postoperative CRT.
  • Median total dose of external RT was 60 Gy for definitive CRT patients, 60 Gy for RT alone, and 40 Gy for preoperative CRT.
  • CONCLUSIONS: This PCS describes general aspects of RT for esophageal cancer in Japan.
  • Squamous cell carcinoma accounted for the majority of patients.
  • The standard total external RT dose for esophageal cancer was higher in Japan than in the United States.
  • Chemoradiotherapy had become common for esophageal cancer treatment, but patients aged > or =75 years were more likely to be treated by RT only.
  • [MeSH-major] Carcinoma, Squamous Cell / radiotherapy. Esophageal Neoplasms / radiotherapy. Health Care Surveys
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / pathology. Adenocarcinoma / radiotherapy. Adenocarcinoma / surgery. Aged. Carcinoma, Adenosquamous / drug therapy. Carcinoma, Adenosquamous / pathology. Carcinoma, Adenosquamous / radiotherapy. Carcinoma, Adenosquamous / surgery. Combined Modality Therapy / methods. Combined Modality Therapy / utilization. Female. Humans. Japan. Male. Middle Aged. Neoplasm Staging. Radiotherapy / methods

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  • (PMID = 19735863.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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19. 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).
  • 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.
  • 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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20. Stilidi I, Davydov M, Bokhyan V, Suleymanov E: Subtotal esophagectomy with extended 2-field lymph node dissection for thoracic esophageal cancer. Eur J Cardiothorac Surg; 2003 Mar;23(3):415-20
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  • [Title] Subtotal esophagectomy with extended 2-field lymph node dissection for thoracic esophageal cancer.
  • OBJECTIVE: To examine the efficacy of the Ivor Lewis esophagectomy with extended 2-field lymph node dissection for thoracic esophageal carcinoma we reviewed our experience.
  • METHODS: We analyzed the cases of 147 consecutive patients who underwent subtotal esophagectomy with extended 2-field lymph node dissection through Ivor Lewis approach for esophageal cancer from January 1996 through December 2000.
  • Eighty-six patients were operated on for cancer of the midthoracic esophagus, 48 for cancer of the lower thoracic esophagus, and 13 for cancer of the aortal segment of the esophagus.
  • No patient had received chemotherapy or radiotherapy before operation.
  • Postsurgical pathological studies revealed squamous cell carcinoma in 139 patients (94.6%), adenocarcinoma in five (3.4%), and adenosquamous carcinoma in three (2%).
  • Postsurgical staging was as follows: stage I in three patients (2%), stage IIa in 20 (13.6%), stage IIb in 29 (19.7%), stage III in 54 (36.8%), and stage IV in 41 (27.9%).
  • The 5-year survival rate for patients in stage IIa was 59%; for those in stage IIb, 39.5%; for patients in stage III, 26.7%; and 0% for patients in stage IV.
  • CONCLUSIONS: Subtotal esophagectomy with extended 2-field lymph node dissection through Ivor Lewis approach for esophageal cancer is a safe operation.
  • Long-term survival is stage dependent.
  • Effective multimodality treatment may be helpful for patients with advanced disease.
  • [MeSH-major] Esophageal Neoplasms / surgery. Esophagectomy / methods
  • [MeSH-minor] Adenocarcinoma / pathology. Adenocarcinoma / secondary. Adenocarcinoma / surgery. Aged. Carcinoma, Adenosquamous / pathology. Carcinoma, Adenosquamous / secondary. Carcinoma, Adenosquamous / surgery. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / secondary. Carcinoma, Squamous Cell / surgery. Female. Humans. Lymph Node Excision. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Prognosis. Survival Rate. Treatment Outcome

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  • (PMID = 12614816.001).
  • [ISSN] 1010-7940
  • [Journal-full-title] European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • [ISO-abbreviation] Eur J Cardiothorac Surg
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] England
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21. Okamura H, Fujiwara H, Suchi K, Okamura S, Umehara S, Konishi H, Todo M, Kubota T, Ichikawa D, Kikuchi S, Okamoto K, Kuriu Y, Ikoma H, Nakanishi M, Ochiai T, Sakakura C, Kokuba Y, Sonoyama T, Otsuji E: [Surgically resected local recurrence after endoscopic submucosal dissection of esophageal cancer--a case report]. Gan To Kagaku Ryoho; 2009 Nov;36(12):2448-50
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  • [Title] [Surgically resected local recurrence after endoscopic submucosal dissection of esophageal cancer--a case report].
  • We report a case of surgically resected esophageal cancer which was locally recurred after endoscopic submucosal dissection.
  • A 66-year-old man was admitted to our hospital because of further examination and a treatment of superficial esophageal cancer.
  • A type 0-IIb+IIa cancer occupying the whole circumference of the lumen of the middle to lower esophagus was revealed.
  • However, macroscopic residual cancer didn't seem to exist.
  • Pathological diagnosis was squamous cell carcinoma, moderately differentiated, the depth of tumor invasion was T1a-LPM.
  • The presence of the residual cancer of the horizontal cut margin could not be judged because en bloc resection could not be achieved.
  • After that, endoscopic balloon dilatation of the esophageal stenosis was performed repeatedly for about one year.
  • Then, he was diagnosed as the local recurrence of the squamous cell carcinoma of the esophagus.
  • The final stage of the lesion was judged T3N1M0 (Stage III, UICC) by the histological examination from the resected specimen.
  • After the operation, he is receiving adjuvant chemotherapy and alive without recurrence.
  • When endoscopic resection of the esophageal cancer is performed to the lesion, which relatively indicated to endoscopic resection or outside the guideline criteria for endoscopic resection, it is important that we choose the appropriate treatment protocol obtaining an informed consent from the patient sufficiently.
  • [MeSH-major] Esophageal Neoplasms / surgery. Esophagectomy. Esophagoscopy
  • [MeSH-minor] Aged. Chemotherapy, Adjuvant. Humans. Male. Neoplasm Recurrence, Local / surgery. Reoperation

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  • (PMID = 20037452.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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22. Launois B, Raoul JL, Leprise E, Meunier B: [Neoadjuvant treatment in surgery of esophageal cancer]. Bull Acad Natl Med; 2000;184(8):1703-13; discussion 1714
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  • [Title] [Neoadjuvant treatment in surgery of esophageal cancer].
  • [Transliterated title] Le traitement néoadjuvant dans la chirurgie du cancer de l'oesophage.
  • We conducted a prospective study on neoadjuvant treatment for squamous cell carcinoma of the esophagus, modifying the chemotherapy protocol by adding l-folinic acid and giving bifractionated radiotherapy with a cis-diaminedichloroplatinum (CDDP) injection before each fraction.
  • Thirty-two patients, 30 men, 2 women, mean age 56.2-8.9 years, with resectable squamous celi carcinoma of the esophagus (TNM stage I = 4, IIA = 4, IIB = 13, III = 11) were included.
  • Chemotherapy, CDDP (80 mg/m2: D2), 5-fluorouracil (5-FU; 600 mg/m2, D1-4), and 1-folinic acid (200 mg/m2, DI-4), was given in two sessions with a 3-week interval during which the patients received radiotherapy (45 Gy), two fractions per day (150 cGy/fraction).
  • Patients underwent surgery 4 to 7 weeks after neoadjuvant therapy.
  • This new therapeutic combination is aggressive and associated with a high postoperative mortality but has a remarkable histological effect since complete response was achieved in 56% (95% CI: 39-73%) of the patients and 5-year survival reached 47%, a very high rate in our experience.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / surgery. Esophagectomy. Neoadjuvant Therapy / methods
  • [MeSH-minor] Cisplatin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Leucovorin / administration & dosage. Male. Middle Aged. Neoplasm Staging. Prospective Studies. Radiotherapy Dosage. Radiotherapy, Adjuvant. Survival Analysis. Treatment Outcome

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  • (PMID = 11471389.001).
  • [ISSN] 0001-4079
  • [Journal-full-title] Bulletin de l'Académie nationale de médecine
  • [ISO-abbreviation] Bull. Acad. Natl. Med.
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil
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23. Adham M, Baulieux J, Mornex F, de La Roche de Bransat E, Ducerf C, Souquet JC, Gerard JP: Combined chemotherapy and radiotherapy followed by surgery in the treatment of patients with squamous cell carcinoma of the esophagus. Cancer; 2000 Sep 1;89(5):946-54
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  • [Title] Combined chemotherapy and radiotherapy followed by surgery in the treatment of patients with squamous cell carcinoma of the esophagus.
  • BACKGROUND: Surgery remains the treatment of choice for patients with esophageal squamous cell carcinoma (SCC), but survival rates have not improved over the past decades.
  • The objective of this study was to evaluate the effect of multimodal therapy on resectability, on the overall and on disease free survival (DFS) rates, and on the laryngeal resection rate.
  • METHODS: Fifty-five patients (49 men and 6 women) with a mean age of 58 +/- 8 years underwent combined modality treatment for esophageal SCC.
  • The tumor location was in the upper one-third of the esophagus in 19 patients, the middle one-third in 22 patients, the lower one-third in 9 patients, and the upper and lower one-thirds in 5 patients.
  • The intent of combined therapy was curative in 87.3% of patients and palliative in 12.7% of patients.
  • Neoadjuvant treatment consisted of two courses of 5-fluorouracil and cisplatin on Days 1-5 and Days 21-25.
  • RESULTS: Full neoadjuvant treatment was possible in 67.3% of patients and was uneventful in 56.
  • The tumor stages according to the American Joint Committee on Cancer staging system were pT0N0 in 12 patients, Stage 0 in 8 patients, Stage IIa in 6 patients, Stage IIb in 6 patients, Stage III in 8 patients, and Stage IV in 13 patients.
  • CONCLUSIONS: Neoadjuvant treatment is tolerated well by most patients.
  • Combination therapy increases the resectability rate and facilitates laryngeal preservation.
  • [MeSH-major] Carcinoma, Squamous Cell / therapy. Esophageal Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Larynx / surgery. Male. Middle Aged. Neoplasm Staging. Postoperative Complications. Survival Rate. Treatment Outcome


24. 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.
  • One hundred and eighty-one out of 187 treatments (55 cycles) were given on an outpatient basis.
  • 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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25. Lü JM, Liang J, Wang JW, He J, Xiao ZF, Zhang HX, Chen DF, Feng QF, Wang LH: [Clinical analysis of 126 patients with primary small cell carcinoma of the esophagus]. Zhonghua Zhong Liu Za Zhi; 2009 Feb;31(2):121-5
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  • [Title] [Clinical analysis of 126 patients with primary small cell carcinoma of the esophagus].
  • OBJECTIVE: To investigate the prognostic factors and the principles of treatment of primary esophageal small cell carcinoma (SCEC) retrospectively.
  • 85 patients were in limited disease stage (LD) and 41 patients as extensive disease stage (ED) according to the Veterans Administration Lung Study Group staging system.
  • Among the 84 patients treated with esophagectomy, 8 cases were in stage I, 16 in stage IIa, 10 in stage IIb, 40 in stage III, 4 in stage IVa and 6 in stage IVb, according to the TNM system (6(th) edition, AJCC).
  • The 1-, 3-, and 5-year overall survival rates (OS) were 52.2%, 15.9%, and 12.2%, respectively, with a median survival time (MST) of 12.5 months.
  • The MST of the patients treated with chemotherapy was 14.5 months, significantly longer than the 5.2 months of the patients without (P = 0.0001).
  • Multivariate analysis showed that stage (HR 1.91, 95% CI 1.26 approximately 2.91, P = 0.002), length of the primary lesion (HR 1.75, 95% CI 1.17 approximately 2.63, P = 0.007), and chemotherapy (HR 0.42, 95% CI 0.28 approximately 0.65, P = 0.000) were independent prognostic factors.
  • CONCLUSION: Esophageal small cell carcinoma is a systemic disease.
  • The tumor stage (LD or ED), length of the primary lesion and chemotherapy are independent prognostic factors.
  • Therefore, a systemic therapy based on chemotherapy should be recommended.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / therapy. Esophageal Neoplasms / therapy. Esophagectomy / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Lymph Node Excision. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Proportional Hazards Models. Radiotherapy, High-Energy. Retrospective Studies. Survival Rate

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  • (PMID = 19538888.001).
  • [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] English Abstract; Journal Article
  • [Publication-country] China
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26. Nemoto K, Ogawa Y, Matsushita H, Takeda K, Takahashi C, Saito H, Takai Y, Yamada S, Hosoi Y: A pilot study of radiation therapy combined with daily low-dose cisplatin for esophageal cancer. Oncol Rep; 2001 Jul-Aug;8(4):785-9
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  • [Title] A pilot study of radiation therapy combined with daily low-dose cisplatin for esophageal cancer.
  • From March 1992 to October 1997, a total of 38 patients with histologically proven esophageal cancer received combination therapy of daily low-dose cisplatin (CDDP) and radiation therapy.
  • The clinical stages (UICC 1997) were I in 3, IIA,B in 13, III in 13, and IVA in 9 patients.
  • All patients received at least 60 Gy of radiation therapy.
  • Of the 38 patients, 14 patients completed full course of chemoradiation therapy.
  • Survival of the stage II-IVA patients who received daily low-dose CDDP and radiation therapy was a little better than that of historical control patients who were treated by radiation therapy alone.
  • Although the results indicate that daily low-dose CDDP combined with radiation therapy may slightly improve the survival of esophageal cancer patients with acceptable toxicity, further efforts should be made to optimize clinical trial protocols.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Cisplatin / therapeutic use. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Aged, 80 and over. Antimetabolites, Antineoplastic / therapeutic use. Combined Modality Therapy. Female. Fluorouracil / therapeutic use. Humans. Male. Middle Aged. Neoplasm Staging. Pilot Projects. Radiotherapy Dosage. Survival Rate. Tomography, X-Ray Computed

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  • (PMID = 11410784.001).
  • [ISSN] 1021-335X
  • [Journal-full-title] Oncology reports
  • [ISO-abbreviation] Oncol. Rep.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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27. Mariette C, Piessen G, Triboulet JP: Therapeutic strategies in oesophageal carcinoma: role of surgery and other modalities. Lancet Oncol; 2007 Jun;8(6):545-53
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  • [Title] Therapeutic strategies in oesophageal carcinoma: role of surgery and other modalities.
  • Traditionally, surgery is considered the best treatment for oesophageal cancer in terms of locoregional control and long-term survival.
  • However, survival 5 years after surgery alone is about 25%, and, therefore, a multidisciplinary approach that includes surgery, radiotherapy, and chemotherapy, alone or in combination, could prove necessary.
  • The role of each of these treatments in the management of oesophageal cancer is under intensive research to define optimum therapeutic strategies.
  • In this report we provide an update on treatment strategies for resectable oesophageal cancers on the basis of recent published work.
  • Results of the latest randomised trials allow us to propose the following guidelines: surgery is the standard treatment, to be used alone for stages I and IIa, or possibly with neoadjuvant chemotherapy or chemoradiotherapy for stage IIb disease.
  • For locally advanced cancers (stage III), neoadjuvant chemotherapy or chemoradiotherapy followed by surgery is appropriate for adenocarcinomas.
  • Chemoradiotherapy alone should only be considered in patients with squamous-cell carcinomas who show a morphological response to chemoradiotherapy, and produces a similar overall survival to chemoradiotherapy followed by surgery, but with less post-treatment morbidity.
  • Although the addition of surgery to chemotherapy or chemoradiotherapy could result in improved local control and survival, surgery should be done in experienced hospitals where operative mortality and morbidity are low.
  • Moreover, surgery should be kept in mind as salvage treatment in patients with no morphological response or persistent tumour after definitive chemoradiotherapy.
  • [MeSH-major] Esophageal Neoplasms / surgery
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Chemotherapy, Adjuvant. Clinical Trials as Topic. Combined Modality Therapy. Humans. Neoadjuvant Therapy / methods. Radiotherapy, Adjuvant

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  • (PMID = 17540306.001).
  • [ISSN] 1470-2045
  • [Journal-full-title] The Lancet. Oncology
  • [ISO-abbreviation] Lancet Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 66
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28. Delcambre C, Jacob JH, Pottier D, Gignoux M, Ollivier JM, Vie B, Roussel A, Segol P: Localized squamous-cell cancer of the esophagus: retrospective analysis of three treatment schedules. Radiother Oncol; 2001 May;59(2):195-201
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  • [Title] Localized squamous-cell cancer of the esophagus: retrospective analysis of three treatment schedules.
  • BACKGROUND AND PURPOSE: A retrospective study comparing chemotherapy and radiation, esophagectomy alone versus preoperative radiochemotherapy and surgery in localized squamous-cell esophageal carcinoma.
  • MATERIALS AND METHODS: Between 1989 and 1995, 139 patients (40 stage I, 77 stage IIA and 22 stage IIB according to the UICC 78 TNM classification) were treated in two different institutions.
  • They were divided into three groups according to the treatment proposed: E group (treatment by esophagectomy; n = 30), RCT+E group (treatment by preoperative radiochemotherapy and esophagectomy; n = 46), RCT group (treatment by radiochemotherapy; n = 63).
  • Factors like age, tumor localization and stage were similar in all groups.
  • CONCLUSIONS: Treatments by esophagectomy or radiochemotherapy were not significantly different.
  • [MeSH-major] Carcinoma, Squamous Cell / therapy. Esophageal Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cause of Death. Cisplatin / administration & dosage. Combined Modality Therapy. Esophagectomy / mortality. Fluorouracil / administration & dosage. Humans. Middle Aged. Mitomycin / administration & dosage. Palliative Care. Radiotherapy Dosage. Retrospective Studies. Survival Analysis

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  • (PMID = 11325449.001).
  • [ISSN] 0167-8140
  • [Journal-full-title] Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
  • [ISO-abbreviation] Radiother Oncol
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Multicenter Study
  • [Publication-country] Ireland
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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29. Servagi-Vernat S, Bosset M, Crehange G, Buffet-Miny J, Puyraveau M, Maingon P, Mercier M, Bosset JF: Feasibility of chemoradiotherapy for oesophageal cancer in elderly patients aged &gt;or=75 years: a prospective, single-arm phase II study. Drugs Aging; 2009;26(3):255-62
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  • [Title] Feasibility of chemoradiotherapy for oesophageal cancer in elderly patients aged >or=75 years: a prospective, single-arm phase II study.
  • BACKGROUND: The number of elderly patients with oesophageal cancer is expected to increase with the aging of the population and the rapidly increasing incidence of adenocarcinoma.
  • Surgical resection is standard treatment for patients with localized disease considered fit for operation.
  • However, elderly patients with oesophageal cancer are rarely referred for surgery.
  • The aim of this prospective, single-arm, phase II study was to evaluate the feasibility and efficacy (tumour response) of chemoradiotherapy in the treatment of elderly patients with localized oesophageal cancer.
  • METHODS: The main study inclusion criteria were: patients aged >or=75 years; oesophageal cancer disease stage II-III; Charlson co-morbidity index score <or=4; Eastern Cooperative Oncology Group (ECOG) performance status 0-2; and weight loss <15%.
  • The radiotherapy regimen consisted of 50 Gy over 5 weeks.
  • The mean age of the patients was 79.4 years (range 75-89 years), 18 were male (81.8%), 15 had squamous cell carcinoma (68%) and 11 had stage IIA disease (50%).
  • All patients were compliant with the planned treatment, including doses and timing.
  • During treatment, ECOG performance status remained stable during the first 3 weeks and worsened slightly over the last 2 weeks.
  • Six weeks after treatment, 14 patients were in complete response (63.6%) and 8 patients (36.4%) had no treatment effect.
  • Four patients (18.2%) were alive without disease from 2.6 to 5.5 years after treatment.
  • In 14 evaluable patients, QOL 6 weeks after treatment was slightly altered by treatment.
  • CONCLUSIONS: The results of this prospective phase II study support the feasibility of chemoradiotherapy for oesophageal cancer in carefully selected elderly patients, with the potential for a curative effect.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Cisplatin / therapeutic use. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / radiotherapy. Aged. Aged, 80 and over. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Combined Modality Therapy. Disease-Free Survival. Female. Follow-Up Studies. Humans. Male. Neoplasm Staging. Prospective Studies. Quality of Life. Survival Rate. Treatment Outcome

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  • (PMID = 19358620.001).
  • [ISSN] 1170-229X
  • [Journal-full-title] Drugs & aging
  • [ISO-abbreviation] Drugs Aging
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] New Zealand
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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