title: A multicentre phase II trial of primary chemotherapy with cisplatin and protracted venous infusion 5-fluorouracil followed by chemoradiation in patients with carcinoma of the oesophagus.
abstract: BACKGROUND
  We undertook a multicentre phase II trial to evaluate the safety and efficacy of primary chemotherapy followed by chemoradiation for localised adenocarcinoma or squamous carcinoma of the oesophagus.
  
  
  METHODS
  Chemotherapy comprised five 3-weekly cycles of cisplatin and protracted continuous infusion 5-fluorouracil, with conformally planned radiotherapy commencing at the start of the fifth cycle.
  
  
  RESULTS
  The planned treatment programme was completed by 39 of 72 patients (54%), and a further 13% completed chemotherapy and proceeded to surgical oesophagectomy. Response rates to chemotherapy and to the entire treatment programme were 47% [95% confidence interval (CI) 34% to 60%] and 56% (CI 43% to 68%). The dysphagia score improved in 54% of patients. The median survival duration was 14.6 months with 1- and 2-year survival rates of 58.7% and 44.1%, respectively. Grade III/IV chemotherapy-related toxicity occurred in 38% of patients, and there were no treatment-related deaths.
  
  
  CONCLUSIONS
  This is a feasible and active treatment regimen providing palliative benefits for patients with poor-prognosis localised oesophageal cancer.
authors.affiliation: Cancer Research Campaign Section of Medicine and Gastrointestinal Unit, Royal Marsden Hospital and Institute of Cancer Research, Sutton, Surrey.
authors.forename: J S
authors.initials: JS
authors.lastname: Waters
authors.forename: D
authors.initials: D
authors.lastname: Tait
authors.forename: D
authors.initials: D
authors.lastname: Cunningham
authors.forename: A R
authors.initials: AR
authors.lastname: Padhani
authors.forename: M E
authors.initials: ME
authors.lastname: Hill
authors.forename: S
authors.initials: S
authors.lastname: Falk
authors.forename: F
authors.initials: F
authors.lastname: Lofts
authors.forename: A
authors.initials: A
authors.lastname: Norman
authors.forename: J
authors.initials: J
authors.lastname: Oates
authors.forename: A
authors.initials: A
authors.lastname: Hill
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D011336:Probability; D011829:Radiation Dosage; D018714:Radiotherapy, Adjuvant / Q000379:methods; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D002945:Cisplatin; D005472:Fluorouracil