The pre-operative treatment of oesophageal carcinoma with synchronously administered chemotherapy and radiotherapy.
Forty-six patients with either squamous cell cancer of the oesophagus or adenocarcinoma involving the lower oesophagus have been treated with synchronously administered radiotherapy and chemotherapy (5FU & Cisplatin) prior to resection of the oesophagus. Endoscopically, complete regression of tumour occurred in 21 patients (46%) and when the oesophagus was resected in these patients, it was found that 11 of the resected specimens contained residual tumour deep to the mucosa. Thus, the actual complete regression rate in the 46 patients was 22%. The postoperative mortality rate was 13% (22% in the first half of the series and 4% in the second half). The median survival rate was 36 months in the 24 patients operated on for squamous cancer of the oesophagus, and 14.5 months in 18 patients operated on for adenocarcinoma of the cardia. Eight patients are alive and disease free at more than three years from surgery, and all of these patients had a squamous cell carcinoma, and all had a complete histological response from their preoperative radiotherapy and chemotherapy.
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