COMBINED CHEMOTHERAPY AND RADIOTHERAPY FOR ESOPHAGEAL-CARCINOMA IN A HEMODIALYZED PATIENT - LONG-TERM SURVIVAL

The use of antimitotic chemotherapy in hemodialysis patients is not ye t well codified, and each individual decision remains difficult. We re port the case of a 68-year-old hemodialyzed man who developed a squamo us cell carcinoma of the upper third of the esophagus. Necessarily dis abling surgery was rejected, and three courses of combined radio- and chemotherapy with 5-fluorouracil and cis-platinum were performed witho ut decreasing standard doses. The percentage of drugs removed during h emodialysis sessions was low; peak and residual platinum plasma concen trations were only slightly above those observed in normal renal funct ion patients. The treatment was perfectly well tolerated, and tumor re sponse was satisfactory without any relapse for 3 years. This observat ion suggests that hemodialysis patients could benefit from such 'full therapies', if necessary, without major adverse effects.