| Comparison between chemoradiation protocol intended for organ preservation and conventional surgery for clinical T1-T2 esophageal carcinoma. | |
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MedLine Citation:
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PMID: 10487546 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: This retrospective study was designed to compare treatment results of the chemoradiation protocol with conventional surgery for thoracic T1-T2 esophageal squamous cell carcinoma. METHODS AND MATERIALS: Sixty-six patients with esophageal carcinoma, clinically diagnosed as T1 (tumor invading lamina propria or submucosa) or T2 (tumor invading muscularis propria) were treated for 12 consecutive years, from July 1986 to January 1998. The conventional surgery group included 30 patients who underwent esophagectomy with regional lymph node dissection. Twenty-one of them received postoperative radiotherapy. Thirty-six patients were assigned to the chemoradiation protocol, consisting of neoadjuvant chemoradiotherapy (44 Gy; CDDP: 60 mg/m2, day 1, bolus; 5-FU: 400 mg/m2, day 1-4, continuous), followed by either definitive radiotherapy with high-dose-rate intraluminal brachytherapy (total 70 Gy) for responders or surgery for nonresponders as in the conventional surgery group. Surgical candidates in both groups received intraoperative radiotherapy for abdominal lymphatics since 1991. RESULTS: In the protocol group, 4 patients underwent radical surgery after neoadjuvant chemoradiotherapy, and the remaining 32 underwent definitive chemoradiotherapy. Local control rates at 1 and 3 years were 85% and 70% in the T1/protocol group versus 91% and 80% in the T1/surgery group, and 83% and 83% in the T2/protocol group versus 94% and 80% in the T2/surgery group, respectively. There was no statistical significance. Overall 1- and 3-year survival rates were 100% and 83% in the T1/protocol group versus 82% and 72% in the T1/surgery group (p = 0.36), and 100% and 51% in the T2/protocol group, versus 95% and 68% in the T2/surgery group p = 0.61), respectively. There was no treatment-related mortality in either group. The rates of esophageal conservation were 92% in the T1/protocol group and 58% in the T2/protocol group. CONCLUSION: The chemoradiation protocol can result in comparable survival with conventional surgery for patients with T1-T2 esophageal carcinoma. A randomized trial between definitive chemoradiotherapy and surgery is required. |
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Authors:
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M Murakami; Y Kuroda; T Nakajima; Y Okamoto; T Mizowaki; F Kusumi; K Hajiro; S Nishimura; S Matsusue; H Takeda |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: International journal of radiation oncology, biology, physics Volume: 45 ISSN: 0360-3016 ISO Abbreviation: Int. J. Radiat. Oncol. Biol. Phys. Publication Date: 1999 Sep |
Date Detail:
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Created Date: 1999-10-04 Completed Date: 1999-10-04 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7603616 Medline TA: Int J Radiat Oncol Biol Phys Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 277-84 Citation Subset: IM |
Affiliation:
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Department of Radiology, Tenri Hospital, Tenri City, Nara Prefecture, Japan. masaomur@yamato.ne.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Antineoplastic Combined Chemotherapy Protocols / therapeutic use Carcinoma, Squamous Cell / mortality, pathology, therapy* Cause of Death Cisplatin / administration & dosage Combined Modality Therapy Esophageal Neoplasms / mortality, pathology, therapy* Female Fluorouracil / administration & dosage Follow-Up Studies Humans Male Middle Aged Neoplasm Invasiveness Neoplasm Recurrence, Local / pathology Neoplasm Staging Radiotherapy Dosage Retrospective Studies Survival Rate |
| Chemical | |
Reg. No./Substance:
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15663-27-1/Cisplatin; 51-21-8/Fluorouracil |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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