title: A comparison of results by sequential and concurrent chemo radiotherapy in locally advanced carcinoma esophagus.
abstract: OBJECTIVE
  Many Trials using sequential and concurrent chemo radiotherapy have been done so far and has established the role of concurrent chemo radiotherapy in treatment of inoperable carcinoma esophagus. In this study, we have compared the results of concurrent chemo radiotherapy with sequential chemo radiotherapy. We have treated inoperable carcinoma esophagus in both the settings and present here the comparison of results in the two settings.
  
  
  METHODS
  There were 26 patients of carcinoma esophagus in sequential and 31 in concurrent chemo radiotherapy arm. In sequential arm methotrexate and Cisplatin followed by radiotherapy was given whereas in concurrent arm, Cisplatin was given once weekly along with radiotherapy.
  
  
  RESULTS
  The 2 year survival was 38% in sequential and35.5% in the concurrent setting and the median survival was 19.5 and 18 months respectively in the two arms.The toxicities in both the arms were comparable. P value of 0.4774 with confidence interval of 95% was obtained, which is not significant. Dysphagia was improved earlier in sequential than in the concurrent arm.
  
  
  CONCLUSIONS
  As the results and toxicities in both the arms are almost similar with better symptom control, so larger randomized trials are required to assess the response and the use of methotrexate in sequential chemo radiotherapy can be further explored.
authors.affiliation: Department of Radiation Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India.
authors.forename: V
authors.initials: V
authors.lastname: Bhandari
authors.forename: K L
authors.initials: KL
authors.lastname: Gupta
authors.forename: R
authors.initials: R
authors.lastname: Taran
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D064420:Drug-Related Side Effects and Adverse Reactions / Q000473:pathology; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D016019:Survival Analysis; D014747:Vinblastine / Q000008:administration & dosage
chemical_list: D014747:Vinblastine; D002945:Cisplatin