title: [Effectiveness and safety of chemoradiation in a community-based population of patients with esophageal cancer].
abstract: BACKGROUND
  In Japan, esophagectomy with three-field lymphadenectomy is the standard therapy for resectable esophageal cancer. However, its outcome is considered unsatisfactory because the 5-year survival rate is less than 50%. Chemoradiotherapy (CRT) is the standard therapy for unresectable esophageal cancer and could also be considered as an option for resectable esophageal cancer. We retrospectively determined the efficacy and safety of CRT for patients with esophageal cancer.
  
  
  METHODS
  The study population comprised patients with esophageal cancer who had been treated with CRT between April 2004 and October 2009 in our institute. Acute and late toxicity was assessed with NCI-CTC and RTOG/EORTC late radiation morbidity scoring scheme, respectively. Survival time was calculated using Kaplan-Meier methods.
  
  
  RESULTS
  We enrolled 29 consecutive patients and classified them on the basis of clinical staging: stage I, 4 patients; stage II/III, 11 patients; and stage IV, 14 patients. Complete response was achieved in 37.9% and 45.5% of the total study population and the stage II/III group, respectively. The median survival time in these groups was 12.1 months and 15 months, respectively. Grade 3/4 acute toxicities were observed in 62.1% of the patients. Grade 3/4 late toxicities were observed in 12% of the patients. The first failure after CRT was almost locoregional.
  
  
  CONCLUSIONS
  CRT appears to be an effective therapy for esophageal cancer; however, its outcome is not satisfactory. Therefore, it is necessary to evaluate the role of salvage surgery after CRT and new chemotherapeutic agents.
authors.affiliation: Dept. of Gastroenterology, Kushiro City General Hospital.
authors.forename: Akira
authors.initials: A
authors.lastname: Goto
authors.forename: Yuka
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Sukawa
authors.forename: Kenichi
authors.initials: K
authors.lastname: Fujii
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Matunaga
authors.forename: Kazuya
authors.initials: K
authors.lastname: Suzuki
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Yonezawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Abe
authors.forename: Hideki
authors.initials: H
authors.lastname: Wakasugi
authors.forename: Miki
authors.initials: M
authors.lastname: Itoh
authors.forename: Ayako
authors.initials: A
authors.lastname: Itoh
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Shinomura
authors.forename: Kenzi
authors.initials: K
authors.lastname: Kagei
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate