CONCURRENT RADIOTHERAPY AND CHEMOTHERAPY WITH PROTRACTED CONTINUOUS-INFUSION OF 5-FLUOROURACIL IN INOPERABLE ESOPHAGEAL SQUAMOUS-CELL CARCINOMA

Purpose: The feasibility of a concurrent chemoradiotherapeutic protoco l for patients with inoperable esophageal squamous cell carcinoma was tested, Methods and Materials: Concurrent chemoradiotherapy using prot racted low-dose continuous infusions of five-fluorouracil (5-FU; 250-3 00 mg/m(2)/24 h) and standard external beam irradiation was given to 2 8 patients with inoperable esophageal squamous cell carcinoma between November 1991 and June 1993, Results: For 25 patients receiving a tota l dose of greater than or equal to 60 Gy and concurrent 5-FU infusion for more than 5 weeks, the complete response rate was 52%, Local progr ession-free rate in this chemoradiotherapy group was significantly hig her than the historical controls treated by radiotherapy alone (p < 0. 05). A multivariate analysis revealed the treatment scheme (concomitan t chemoradiotherapy vs, radiotherapy alone) to be a significant factor in local control (p < 0.01), Swallowing pain (39%), anorexia (39%), a nd nausea (32%) were the most frequent early reactions. Serious late r adiation complications have not been observed, Conclusion: The concurr ent chemoradiotherapy using protracted low-dose continuous infusion of 5-FU and standard radiotherapy is an effective and safe method to obt ain a local control in inoperable esophageal squamous cell carcinoma.