title: Neoadjuvant chemotherapy and radiotherapy in locally advanced esophagus carcinoma: long-term results.
abstract: OBJECTIVE
  A prospective study with neoadjuvant chemotherapy and radiotherapy in patients with locally advanced esophagus carcinoma for evaluating: toxicity, response rate, pattern of recurrence, and survival after a long follow-up.
  
  
  METHODS
  Between 1983-1988, 40 patients with locally advanced squamous cell carcinoma of the thoracic esophagus were entered into a prospective trial of neoadjuvant chemotherapy and radiotherapy. Eight patients (20%) were Stage II and 32 patients (80%) were Stage III, according to American Joint Committee staging criteria. Neoadjuvant chemotherapy consisted of two cycles with cisplatin (120 mg/m2 day 1), vindesine (3 mg/m2 days 1, 8, 15, and 22) and bleomycin (10 mg/m2 days 3 to 6). Second cycle was initiated on day 29. Radiation therapy was administered 2-4 weeks after completion of chemotherapy, with a total dose on tumor of 60 Gy.
  
  
  RESULTS
  Two patients died from treatment-related toxicity. Complete response was observed in 20 patients (53%) and symptomatic improvement in 31 patients (82%). The median survival was 11 months, with an actuarial survival at 1 year of 45%, 3 year 20%, and 5 years 15%. Significantly (p < 0.05) longer survival was observed in patients with Stage II (median survival 18 months) vs. Stage III (median survival 10 months). The pattern of failure was predominantly local/regional (62%).
  
  
  CONCLUSIONS
  This treatment scheme is an effective and tolerable regimen but long-term survival was poor.
authors.affiliation: Department of Oncology, Hospital de Navarra, Pamplona, Spain.
authors.forename: J J
authors.initials: JJ
authors.lastname: Valerdi
authors.forename: M
authors.initials: M
authors.lastname: Tejedor
authors.forename: J J
authors.initials: JJ
authors.lastname: Illarramendi
authors.forename: M A
authors.initials: MA
authors.lastname: Dominguez
authors.forename: F
authors.initials: F
authors.lastname: Arias
authors.forename: E
authors.initials: E
authors.lastname: Martinez
authors.forename: R
authors.initials: R
authors.lastname: Lopez
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000453:epidemiology / Q000532:radiotherapy*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors; D014751:Vindesine / Q000008:administration & dosage
chemical_list: D001761:Bleomycin; D002945:Cisplatin; D014751:Vindesine