title: Intense therapy in patients with locally advanced esophageal cancer beyond hope for surgical cure: a prospective, multicenter phase II trial of the Swiss Group for Clinical Cancer Research (SAKK 76/02).
abstract: BACKGROUND
  There is no standard treatment for patients with locally advanced esophageal carcinoma without systemic metastasis in whom surgery is no longer considered a reasonable option.
  
  
  METHODS
  Patients with cervical esophageal tumors, locally very advanced stage (T4 and/or M1a) or locally advanced (T3 and/or N+) with comorbidities were included.
  
  
  METHODS
  2 cycles of induction chemotherapy (cisplatin and docetaxel, both 75 mg/m(2) 3-weekly) followed by chemoradiation therapy (CRT) comprising a total radiation dose of 59.4 Gy together with docetaxel 15 mg/m(2) and cisplatin 25 mg/m(2) (5 weekly doses). Primary endpoint: Histologically proven freedom from local failure 6 months after CRT completion.
  
  
  RESULTS
  21 patients were included: 12 had locally very advanced tumors, 3 had cervical esophagus tumors, and 6 were medically unfit for surgery. 18 patients completed therapy per protocol. Grade 3/4 toxicities during CRT were thrombopenia (10%) and dysphagia (15%). 1 patient died due to herpes simplex infection. The primary endpoint was achieved by 4 patients, 6 were alive after median follow-up of 34 months, and median survival was 16 months. Most patients experienced lasting improvement of dysphagia following induction chemotherapy.
  
  
  CONCLUSIONS
  This regimen is feasible, showed clinically meaningful, long-lasting improvements in quality of life and resulted in long-term survival in 29% of the patients.
authors.affiliation: Fachbereich Onkologie/Hämatologie, Kantonsspital St. Gallen, St. Gallen, Switzerland. thomas.ruhstaller@kssg.ch
authors.forename: Thomas
authors.initials: T
authors.lastname: Ruhstaller
authors.forename: Arnoud
authors.initials: A
authors.lastname: Templeton
authors.forename: Karin
authors.initials: K
authors.lastname: Ribi
authors.forename: Jan C
authors.initials: JC
authors.lastname: Schuller
authors.forename: Markus
authors.initials: M
authors.lastname: Borner
authors.forename: Sandra
authors.initials: S
authors.lastname: Thierstein
authors.forename: Roger
authors.initials: R
authors.lastname: von Moos
authors.forename: Stefanie
authors.initials: S
authors.lastname: Pederiva
authors.forename: Andreas
authors.initials: A
authors.lastname: Lohri
authors.forename: Norbert
authors.initials: N
authors.lastname: Lombriser
authors.forename: Christian
authors.initials: C
authors.lastname: von Briel
authors.forename: Dieter
authors.initials: D
authors.lastname: Koeberle
authors.forename: Razvan
authors.initials: R
authors.lastname: Popescu
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal