SEQUENTIAL CHEMOTHERAPY AND RADIOTHERAPY FOR PATIENTS WITH SQUAMOUS-CELL CARCINOMA OF THE ESOPHAGUS

Background. Despite surgical improvements the prognosis of patients wi th squamous cell carcinoma (SCC) of the esophagus remains poor, with a 5-year survival rate of less than 20%. Most patients do not undergo s urgery with curative intent. The aim of this study was to assess the t oxicity and efficacy of sequential chemoradiotherapy. Methods. Between May 1986 and June 1991, 50 patients with nonmetastatic SCC of the eso phagus were included in this study. Three patients had recurrence afte r surgery, 8 patients were classified Stage I disease, 24 Stage II, 5 Stage III, and 10 Stage VI. Treatment consisted of cisplatin (100 mg/m (2) on Days 1 and 29), 5-fluorouracil (5-FU) (600 mg/m(2) on Days 2-9 and Days 30-33) and 30 Gy of radiotherapy (2 Gy X 15 on Days 8-26 and 30 Gy on Days 36-54). Results. Thirty-seven patients (74%) received th e whole treatment course; treatment was modified for 8 patients becaus e of Grades III and IV hematologic, digestive, or renal toxicity. Five patients did not complete treatment because of disease progression or death. Median survival was 13 months; 1- and 2- year survival rates w ere 63% (49-75) and 36% (25-50), respectively. No late treatment compl ications were observed (in the 11 survivors after 2 years). Conclusion s. Sequential chemoradiotherapy of SCC of the esophagus was well toler ated with acceptable acute morbidity and resulted in local control and survival results at least equivalent to those in trials of neoadjuvan t chemoradiotherapy plus surgery.