title: [Five cases of advanced gastroesophageal junction adenocarcinoma successfully treated with chemoradiotherapy followed by curative resection].
abstract: We reviewed five patients with advanced gastroesophageal cancer who were successfully treated with chemoradiotherapy followed by a curative resection. Patients with histologically-documented adenocarcinoma of the gastroesophageal junction were eligible. Direct tumor extension into the stomach (cT3 or cT4), and involvement of lymph nodes were observed. The patients stopped receiving orally administered carcinostatic drugs due to digestive stenosis or tumor bleeding. They received 25 mg/m2 of cisplatin and 60 mg/m2 of paclitaxel once a week on days 1, 8, 15 and 22. Radiation was administered concurrently at a total dose of 45 Gy in 1.8 Gy fractions for over 25 treatments. Effectiveness of the therapy was evaluated 4 weeks after the chemoradiotherapy. All patients with clinical partial responses underwent gastrectomy (n=4) or esophagogastrectomy (n=1). Curative resection was performed in 5 patients (resection A/B 4/1), and no patient suffered from major postoperative complications. Four patients were downstaged according to the pathological findings. The histologically effective responses of all patients were Grade 2. The obvious chemotherapeutic efficacy of the present regimen suggested that it may be a good treatment option for advanced gastroesophageal cancers. Further studies including randomized controlled trials are needed to evaluate the significance of preoperative chemoradiotherapy.
authors.affiliation: Dept. of Surgery, Iwate Medical University.
authors.forename: Masanori
authors.initials: M
authors.lastname: Takahashi
authors.forename: Keisuke
authors.initials: K
authors.lastname: Koeda
authors.forename: Hisataka
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Takehiro
authors.initials: T
authors.lastname: Chiba
authors.forename: Akira
authors.initials: A
authors.lastname: Sasaki
authors.forename: Go
authors.initials: G
authors.lastname: Wakabayashi
mesh_terms: D000230:Adenocarcinoma / Q000628:therapy*; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D016629:Esophagectomy; D004943:Esophagogastric Junction; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel; D002945:Cisplatin