Chemoradiotherapy Experience in Locally Advanced Esophageal Cancer

Objective: In this study, we report our neoadjuvant/definitive chemoradiotherapy (CRT) experience in locally advanced esophageal cancer patients.Patients and Methods: A total of 15 patients were retrospectively evaluated. Histological diagnosis were as follows: squamous cell 10, adenocarcinoma 4, adenosquamous carcinoma1. Initial stage was T3N0M0 5 or T3N1M0/T4N0M0 10. Radiotherapy was administered at median of 50 Gy (1.8-2 Gy/day, 5 fractions/week) and cisplatin and 5-fluorouracil were given concurrently on the first and the last week of radiotherapy.Results: Continuous applicability of concurrent chemoradiotherapy was 80%. Median follow-up was 15 months (range, 3-70 months). One of the five patients who were treated with neoadjuvant approach had local progression,and three had distant metastasis. Three patients (30%) who were planned to be treated with definitive CRT had downstaging and surgery was recommended. Two-year local control rate was 22%, distant metastasis-free survival rate was 45% and overall survival rate was 31%. Grade III dysphagia was observed in 6% of patients.Conclusion: Treatment of locally advanced esophageal cancer remains controversial. Although patients who had surgery were reported to have longer survival and better local control rates, the feasibility of triple-modality treatment is limited to the center's experience. For this reason, all patients should be evaluated individually with a multidisciplinary approach. (Marmara Medical Journal 2012;25:74-7)