PHASE-II TRIAL OF 5-FLUOROURACIL, LEUCOVORIN, INTERFERON-ALPHA-2A, AND CISPLATIN AS NEOADJUVANT CHEMOTHERAPY FOR LOCALLY ADVANCED ESOPHAGEAL-CARCINOMA

BACKGROUND. Most patients with esophageal carcinoma present with local ly advanced disease and a poor prognosis. Surgery or radiation provide s palliation for locally advanced esophageal carcinoma. The role of ne oadjuvant therapy remains to be defined. We administered neoadjuvant c hemotherapy consisting of 5-fluorouracil (5-FU), leucovorin, interfero n-alpha-2a, and ciplastin to 11 patients with locally advanced disease . METHODS. Eleven patients with squamous cell or adenocarcinoma of the esophagus were treated preoperatively with two to three cycles of com bination chemotherapy. Nine patients underwent resection with curative intent. RESULTS. Six patients received three cycles of chemotherapy, and five received two. Dose reduction was necessary for two patients. One patient achieved a pathologic complete response, histologically co nfirmed. Of the eleven patients, two did not undergo surgery because o f progressive disease during chemotherapy. Seven of the 9 patients rel apsed after surgery and 2 have been disease free for 27 months. CONCLU SIONS. The combination 5-FU, leucovorin, interferon-alpha-2a, and cisp latin administered in a neoadjuvant setting resulted in a median survi val of 11.8 months with a median time to relapse of 7 months. (C) Amer ican Cancer Society.