Induction chemotherapy followed by concurrent chemotherapy and high-dose radiotherapy for locally advanced squamous cell carcinoma of the cervical oesophagus

The efficacy and toxicity of combined radiochemotherapy for locally advance d squamous cell carcinomas of the cervical oesophagus was evaluated retrosp ectively. Induction chemotherapy consisted of three courses of 5-fluorourac il (5-FU), leucovorin, etoposide and cisplatin (FLEP) or two courses weekly six times of 5-FU and leucovorin combined with biweekly cisplatin. This in duction regimen was followed by high-dose external beam radiotherapy up to 60-66 Gy and concurrent chemotherapy with cisplatin and etoposide, Median f ollow-up of the recruited 17 patients was 37 months (13-73 months). Long-te rm survival was 24% at 2 and 3 years, The probabilities of locoregional tum our recurrences and distant metastases as sites of first relapse were 67 an d 39% at 2 years. Acute and late toxicity of this schedule was moderate. Th e protocol offers a definitive chance of longterm survival for patients wit h locally advanced carcinomas of the cervical oesophagus, but local in-fiel d recurrences remain the predominant risk after treatment. Intensification of the regimen seems possible because no dose-limiting late toxicities were observed.