Treatment of esophageal carcinoma combined preoperative chemotherapy.
Thirty-four patients with epidermoid carcinoma of the esophagus received a triple-drug regimen preoperatively consisting of cisplatin, vindesine, and bleomycin. Partial response to chemotherapy (greater than 50% reduction in measurable tumor size with concomitant improvement in swallowing function) was noted in 65% of the patients. Of the 34 patients, 28 (82%) had resectable disease. A one-stage high esophagogastrectomy utilizing the end-to-end anastomosis stapling device was performed on all 28 patients. Operation was followed by external radiation therapy to the esophageal bed, to a tumor dose of 5,500 rads delivered in 5 weeks. The postoperative median follow-up is now 14 months (range, 7 to 36 months). Thirteen patients are alive and well, and 10 patients have relapsed, 4 of whom are still alive with disease. Two patients died of postoperative complications, and 1 death was drug related. On the other hand, 5 of the 6 patients with unresected tumors died within 5 months. While the preliminary results are encouraging, longer follow-up will be required to determine whether the response rate to chemotherapy will result in a longer disease-free interval and longer survival.
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001761:Bleomycin / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000601:surgery; D002945:Cisplatin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000601:surgery; D004947:Esophagus / Q000601:surgery; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D014747:Vinblastine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014751:Vindesine
D000970:Antineoplastic Agents; D001761:Bleomycin; D014747:Vinblastine; D002945:Cisplatin; D014751:Vindesine