title: Treatment results of chemoradiotherapy for clinical stage I (T1N0M0) esophageal carcinoma.
abstract: OBJECTIVE
  In 1991, we started a clinical prospective trial for operable esophageal carcinoma, foreseeing organ preservation, to assess the treatment results after definitive chemoradiotherapy (CRT) for clinical Stage I (T1N0M0) esophageal cancer.
  
  
  METHODS
  Between 1992 and 2003, 63 patients were enrolled in this study. Tumor depth was mucosal cancer (T1a) in 23 and submucosal cancer (T1b) in 40. CRT consisted of 55-66 Gy/50-60 fractions (median, 59.4 Gy); from 1 to 3 cycles (median, 2) of concurrent chemotherapy (Cisplatin and 5-fluorouracil), followed by high-dose-rate intraluminal brachytherapy 10-12 Gy/2-3 fractions.
  
  
  RESULTS
  The 5-year overall and cause-specific and disease-free survival rates were 66.4%, 76.3%, and 63.7%, respectively. The 5-year cause-specific survival rates for T1a and T1b cancer patients were 85.2% and 70.0%, respectively (p = 0.06). The 5-year disease-free survival rates for T1a and T1b were 84.4% and 50.5%, respectively (p < 0.01). Esophageal fistula as a late toxicity occurred in 2 patients (G4: 1; G5: 1), and esophageal stricture requiring a liquid diet occurred in 2 patients. Pericardial effusion was observed in 3 patients.
  
  
  CONCLUSIONS
  We confirmed that patients with T1N0M0 esophageal carcinoma had their esophagus preserved in 89.2% of cases after definitive CRT, and the survival rates were equivalent to those of previous reports of surgery.
authors.affiliation: Department of Therapeutic Radiology, Tenri Hospital, Nara, Japan. kyamada-rad@umin.ac.jp
authors.forename: Kazunari
authors.initials: K
authors.lastname: Yamada
authors.forename: Masao
authors.initials: M
authors.lastname: Murakami
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Yoshishige
authors.initials: Y
authors.lastname: Okuno
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Nakajima
authors.forename: Fusako
authors.initials: F
authors.lastname: Kusumi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takakuwa
authors.forename: Satoru
authors.initials: S
authors.lastname: Matsusue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy / Q000379:methods; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D016629:Esophagectomy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D016019:Survival Analysis; D017211:Treatment Failure
chemical_list: D002945:Cisplatin; D005472:Fluorouracil