Chemoradiotherapy plus Surgery Improves Esophageal Cancer Survival

Posted on July 19th, 2010 by

Among patients with cancer of the esophagus or esophagogastric junction, treatment with chemotherapy and radiation therapy prior to surgery resulted in better overall survival than surgery alone. The results of this Phase III clinical trial were presented at the 2010 annual meeting of the American Society of Clinical Oncology.

The esophagus is a muscular tube that food and liquids pass through on their way to the stomach. Each year in the United States, more than 16,000 people are diagnosed with cancer of the esophagus and more than 14,000 die of the disease.

For patients with esophageal cancers that can be surgically removed, surgery plays in an important role in treatment. To explore whether chemotherapy and radiation therapy prior to surgery improves outcomes among patients with operable esophageal cancer, researchers in the Netherlands conducted a Phase III clinical trial among 363 patients. Patients were assigned to treatment with surgery alone or with chemotherapy and radiation therapy followed by surgery. Chemotherapy—which was administered concurrently with radiation therapy—consisted of paclitaxel and carboplatin.

  • Overall survival at one year was 82% among patients treated with preoperative chemotherapy and radiation therapy compared with 70% among patients treated with surgery alone.
  • By three years, overall survival was 59% among patients treated with preoperative chemotherapy and radiation therapy compared with 48% among patients treated with surgery alone.
  • The benefit of preoperative chemotherapy and radiation therapy appeared to vary by type of esophageal cancer: the benefit was more apparent among patients with squamous cell cancers than patients with adenocarcinomas.

The results of this study suggest that preoperative chemotherapy and radiation therapy benefit some patients with operable cancer of the esophagus or esophagogastric junction.

Reference: Gaast AV, van Hagen P, Hulshof M et al. Effect of preoperative concurrent chemoradiotherapy on survival of patients with resectable esophageal or esophagogastric junction cancer: Results from a multicenter phase III study. Presented at the 2010 annual meeting of the American Society of Clinical Clinical Oncology, Chicago, IL, June 4-8, 2010. Abstract 4004.

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