Title of article :
Safety, Tolerability and Efficacy of Neoadjuvant Chemoirradiation for Operable Esophageal Carcinoma, a Case Series Study
Author/Authors :
ABDOU, EHAB Al-Azhar University - Faculty of Medicine - Department of Radiation Oncology, Egypt , SAFWAT, REHAM Zagazig University - Faculty of Medicine - Department of Radiation Oncology, Egypt , EDAROUS, MAHER Zagazig University - Faculty of Medicine - Department of Radiation Oncology, Egypt , EL-BASMY, AMANI Cairo University - National Cancer Institute - Department of Epidemiology, Egypt , FOUAD, EMAN Ain Shams University - Faculty of Medicine - Department of Radiation Oncology, Egypt , AL-SHAHHAT, KHALID Al-Azhar University - Faculty of Medicine - Department of Radiation Oncology, Egypt , SAKR, HAMDY Al-Azhar University - Faculty of Medicine - Department of Radiation Oncology, Egypt , EL-DWENY, HANY National Cancer Institute - Faculty of Medicine - Department of Surgical Oncology, Egypt , ABDEL GAWAD, WAEL S. National Cancer Institute - Faculty of Medicine - Department of Surgical Oncology, Egypt , EL-SAYED, AHMED Cairo University - National Cancer Institute - Department of Surgical Oncology, Egypt , MONIB, SHERIF Cairo University - National Cancer Institute - Department of Surgical Oncology, Egypt
Abstract :
Objective: To assess the safety, tolerability and efficacy of concurrent chemotherapy and radiotherapy in patients with operable carcinoma of the esophagus.Design: A case series descriptive study.Patients and Methods: Twenty patients with operable carcinoma of the esophagus were recruited between January 2003 and December 2005. The study closure was on October 2007.The clinical staging of patients was Tl-3 N0-1 M0, PS 0-2. Their malignancies were pathologically confirmed to be either squamous cell carcinoma or adenocarcinoma of the esophagus. All eligible 20 patients were subjected to chemo irradiation in the form of 45 Gy in 25 fractions over 5 weeks concurrently with cisplatin 75 mg/m2 intravenously on the first day and fluorouracil, 1 g/m2 per day by continuous infusion on the first 4 days of weeks 1,5,8 and 11. All patients were followed up for a median duration of 22 months (range 18-54 months).Results: Chemotherapy was administered as planned in 15 (75%) patients. Two patients (10%) had life-threatening (septic shock) toxic effects that led to protracted treatment course. Ten patients (50%) had clinical complete response (CR) while 7 only (35%) had pathological CR. There were 3 (15%) patients who had stable disease (SD). By the end of the study there were 7 patients alive (35%); 4 (20%) were alive free of disease and 3 (15%) were alive with local recurrence.Conclusion: This study showed that combined preoperative chemoirradiation for operable esophageal carcinoma is a relatively tolerable treatment that leads to better overall survival, disease free survival if compared with other studies using RT alone.
