title: Chemoradiotherapy alone as the standard treatment of epidermoid esophageal carcinoma.
abstract: OBJECTIVE
  Surgery has traditionally been the treatment of choice for patients with potentially resectable esophageal carcinoma. Recently, however, definitive chemoradiotherapy (CRT) has been suggested as a preferred treatment modality. In this study, CRT results with or without surgery are compared.
  
  
  METHODS
  A total of 986 patients of esophageal carcinoma were categorized into two groups depending on the treatment: surgery (675 patients) or CRT (311 patients). These two groups were compared based on age, sex, weight loss, tumor location and length, tumor shape, grade, stage, delay in receiving treatment, event-free survival (EFS) and overall survival (OS).
  
  
  RESULTS
  Patients in the CRT arm were significantly older (p = 0.01), had a more significant adenocarcinoma histology (p = 0.015), upper esophageal carcinoma (p = 0.0001) and more advanced stages of the disease (p = 0.0001). The median EFS for the surgery group was 24.5 months [95% confidence interval (CI), 17-32] versus 22.5 months (95% CI, 16.7-28.2) for the CRT arm (p = 0.56). The mean OS was 59.25 months (95% CI, 53.8-64.7) for the surgery group compared to 58.77 months (95% CI, 50.9-66.6) for the CRT group (p = 0.78).
  
  
  CONCLUSIONS
  Definitive CRT is effective enough so as to consider omitting surgery and could be used as a standard treatment for patients with esophageal carcinoma.
authors.affiliation: Department of Radiation Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. salekr@mums.ac.ir
authors.forename: Roham
authors.initials: R
authors.lastname: Salek
authors.forename: Fatemeh Varshoee
authors.initials: FV
authors.lastname: Tabrizi
authors.forename: Safa Esmailpoor
authors.initials: SE
authors.lastname: Bezenjani
authors.forename: Hamid Saeidi
authors.initials: HS
authors.lastname: Saedi
authors.forename: Mohamad Hasan Hosainzad
authors.initials: MH
authors.lastname: Ashkiki
authors.forename: Seid Mohsen
authors.initials: SM
authors.lastname: Hosainzadeh
authors.forename: Samira
authors.initials: S
authors.lastname: Mohtashami
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D016001:Confidence Intervals; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D016019:Survival Analysis; D016896:Treatment Outcome