title: Multicenter phase II trial of preoperative induction chemotherapy followed by chemoradiation with docetaxel and cisplatin for locally advanced esophageal carcinoma (SAKK 75/02).
abstract: BACKGROUND
  This multicenter phase II study investigated the efficacy and feasibility of preoperative induction chemotherapy followed by chemoradiation and surgery in patients with esophageal carcinoma.
  
  
  METHODS
  Patients with locally advanced resectable squamous cell carcinoma or adenocarcinoma of the esophagus received induction chemotherapy with cisplatin 75 mg/m(2) and docetaxel (Taxotere) 75 mg/m(2) on days 1 and 22, followed by radiotherapy of 45 Gy (25 x 1.8 Gy) and concurrent chemotherapy comprising cisplatin 25 mg/m(2) and docetaxel 20 mg/m(2) weekly for 5 weeks, followed by surgery.
  
  
  RESULTS
  Sixty-six patients were enrolled at eleven centers and 57 underwent surgery. R0 resection was achieved in 52 patients. Fifteen patients showed complete, 16 patients nearly complete and 26 patients poor pathological remission. Median overall survival was 36.5 months and median event-free survival was 22.8 months. Squamous cell carcinoma and good pathologically documented response were associated with longer survival. Eighty-two percent of all included patients completed neoadjuvant therapy and survived for 30 days after surgery. Dysphagia and mucositis grade 3/4 were infrequent (<9%) during chemoradiation. Five patients (9%) died due to surgical complications.
  
  
  CONCLUSIONS
  This neoadjuvant, taxane-containing regimen was efficacious and feasible in patients with locally advanced esophageal cancer in a multicenter, community-based setting and represents a suitable backbone for further investigation.
authors.affiliation: Department of Oncology and Hematology, Kantonsspital, St Gallen, St Gallen. Electronic address: thomas.ruhstaller@kssg.ch.
authors.forename: T
authors.initials: T
authors.lastname: Ruhstaller
authors.affiliation: Department of Oncology, Triemlispital Zurich, Zurich.
authors.forename: L
authors.initials: L
authors.lastname: Widmer
authors.affiliation: Coordination Center, SAKK Bern, Bern.
authors.forename: J C
authors.initials: JC
authors.lastname: Schuller
authors.affiliation: Oncosurgery, Department of Surgery, University Hospital of Geneva, Geneva.
authors.forename: A
authors.initials: A
authors.lastname: Roth
authors.affiliation: Division of Medical Oncology, Department of Internal Medicine, University Hospital of Basel, Basel.
authors.forename: V
authors.initials: V
authors.lastname: Hess
authors.affiliation: Department of Oncology and Hematology, Kantonsspital Aarau, Aarau.
authors.forename: W
authors.initials: W
authors.lastname: Mingrone
authors.affiliation: Department of Medical Oncology and Hematology, Kantonsspital Graubünden, Chur.
authors.forename: R
authors.initials: R
authors.lastname: von Moos
authors.affiliation: Institute of Medical Oncology, Inselspital Bern, Bern.
authors.forename: M
authors.initials: M
authors.lastname: Borner
authors.affiliation: Department of Oncology, University Hospital of Zurich, Zurich.
authors.forename: B C
authors.initials: BC
authors.lastname: Pestalozzi
authors.affiliation: Department of Radiation Oncology, University Hospital of Geneva, Geneva.
authors.forename: S
authors.initials: S
authors.lastname: BalmerMajno
authors.affiliation: Department of Oncology and Hematology, Kantonsspital, St Gallen, St Gallen.
authors.forename: D
authors.initials: D
authors.lastname: Köberle
authors.affiliation: Institute of Pathology, University Hospital of Basel, Basel.
authors.forename: L
authors.initials: L
authors.lastname: Terraciano
authors.affiliation: Department of Surgery, Triemlispital Zurich, Zurich.
authors.forename: A
authors.initials: A
authors.lastname: Schnider
authors.affiliation: Institute for Radio-Oncology, Kantonsspital Aarau, Aarau.
authors.forename: S
authors.initials: S
authors.lastname: Bodis
authors.affiliation: Tumor Center, Hirslanden Clinic Aarau, Aarau, Switzerland.
authors.forename: R
authors.initials: R
authors.lastname: Popescu
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002277:Carcinoma / Q000401:mortality / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D013505:Digestive System Surgical Procedures; D000077143:Docetaxel; D004938:Esophageal Neoplasms / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011878:Radiotherapy; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin