title: [Neoadjuvant chemoradiotherapy for advanced esophageal cancer].
abstract: The limitations of surgical treatment for advanced esophageal cancer have been clarified, although esophagectomy with extended lymph node dissection has been widespread in Japan. Preoperative adjuvant therapy has been investigated in Western countries, and recently preoperative chemoradiotherapy (CRT) has been introduced for the treatment of resectable esophageal cancer. There are several reports of randomized controlled trials (RCTs) comparing CRT followed by surgery and surgery alone. According to the results of a meta-analysis, preoperative CRT is considered to be the standard therapy in Western countries. However, problems in the clinical heterogeneity of meta-analyses include: small number of patients in each RCT; differences in stage grouping; presence of both squamous cell carcinoma and adenocarcinoma; various surgical techniques used; and differences in the amount of radiation administered. Preoperative CRT appears to be a promising method for the treatment of potentially resectable advanced esophageal cancer patients with nodal metastasis. Currently, phase I and II trials of new anticancer agents or molecular targeting agents are ongoing. However, since the surgical procedure in the Western method is still being debated, well-designed RCTs are necessary, especially in esophageal squamous cell carcinoma. The effectiveness of CRT followed by surgery should be clarified based on excellent Japanese surgical techniques.
authors.affiliation: Department of Surgical Oncology and Digestive Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
authors.forename: Masataka
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okumura
authors.forename: Yasuto
authors.initials: Y
authors.lastname: Uchikado
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Setoyama
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kita
authors.forename: Takaaki
authors.initials: T
authors.lastname: Arigami
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Uenosono
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Owaki
authors.forename: Sumiya
authors.initials: S
authors.lastname: Ishigami
mesh_terms: D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000628:therapy*; D006801:Humans; D015201:Meta-Analysis as Topic; D020360:Neoadjuvant Therapy; D016032:Randomized Controlled Trials as Topic