Professor de Manzoni and colleagues from Italy analyzed chemoradiotherapy for squamous cell carcinoma of the thoracic esophagus.
The research team evaluated the long-term results of an increase in the dosage of an induction chemoradiotherapy protocol.
The team considered 2 groups of 177 patients.
The patients underwent preoperative chemoradiotherapy for squamous cell carcinoma of the thoracic esophagus.
Group A included 111 patients from 1987 to 1995 who were submitted to cisplatin and 5-fluorouracil and radiotherapy.
Group B included 66 patients from 1995 to 2002 in which the doses were raised both in terms of chemotherapy and radiotherapy.
The induction treatment was completed in 92% of the patients with an acceptable treatment-related mortality of 3%.
The team reported that surgery was accomplished in 78% in Group A and 92% in Group B.
|Tumor resection occurred in 92% with a better R0-resection on higher doses|
|Annals of Thoracic Surgery|
Anaesthesia was induced with vecuronium 0.1 mg kg-1 and propofol 2 mg kg-1.
The researchers found that the postoperative in-hospital mortality was 9%.
Tumor resection was possible in 92% with a better R0-resection rate for Group B.
The team noted that responders represented 35% of the patients with 20% of "complete" responses, with 30% in Group B.
The overall 5-year survival rate was improved in Group B, and when survival analysis was restricted to responders.
Professor de Manzoni's team concluded, “No differences in feasibility and complication rate were observed during the 2 study periods.”
“A higher rate of R0-resections was achieved in Group B.”
“The increased dosage led to an increased rate of complete responses and to an improved overall 5-year survival.”