title: A clinical trial of neoadjuvant concurrent chemoradiotherapy followed by resection for esophageal carcinoma.
abstract: BACKGROUND
  Esophageal carcinoma is a common malignancy in the North East of Iran. Combined modality treatments have been adopted to improve survival in patients with esophageal carcinoma. In this trial, we evaluated the efficacy and toxicity of a preoperative concurrent chemoradiotherapy protocol in the patients with locally advanced esophageal carcinoma.
  
  
  METHODS
  Between 2006 and 2011, eligible patients with locally advanced esophageal carcinoma underwent concurrent radiotherapy and chemotherapy and 3-4 weeks later, esophagectomy. Pathologic response, overall survival rate, toxicity, and feasibility were evaluated.
  
  
  RESULTS
  One hundred ninety-seven patients with a median age of 59 (range: 27-70) entered the protocol. One hundred ninety-four cases (98.5%) had esophageal squamous cell carcinoma. Grades 3-4 of toxicity in patients undergoing neoadjuvant chemoradotherapy were as follows: Neutropenia in 21% and esophagitis in 2.5% of cases. There were 11 (5.6%) early death probably due to the treatment-related toxicities. One hundred twenty-seven patients underwent surgery with postsurgical mortality of 11%. In these cases, the complete pathological response was shown in 38 cases (29.9%) with a 5-year overall survival rates of 48.2% and median overall survival of 44 months (95% confidence interval, 24.46-63.54).
  
  
  CONCLUSIONS
  The pathological response rate and the overall survival rate are promising in patients who completed the protocol as receiving at least one cycle of chemotherapy. However, the treatment toxicities were relatively high.
authors.affiliation: Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Kazem
authors.initials: K
authors.lastname: Anvari
authors.affiliation: Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Seyed Amir
authors.initials: SA
authors.lastname: Aledavood
authors.affiliation: Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mehdi Seilanian
authors.initials: MS
authors.lastname: Toussi
authors.affiliation: Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mohammad Naser
authors.initials: MN
authors.lastname: Forghani
authors.affiliation: Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Samira
authors.initials: S
authors.lastname: Mohtashami
authors.affiliation: Endoscopic and Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mohammad Taghi
authors.initials: MT
authors.lastname: Rajabi
authors.affiliation: Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Fatemeh Homaee
authors.initials: FH
authors.lastname: Shandiz
authors.affiliation: Omid Hospital, Radiation Oncology Specialist, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Nosrati
authors.affiliation: Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Gholamhossein
authors.initials: G
authors.lastname: Nowferesti
authors.affiliation: Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Roham
authors.initials: R
authors.lastname: Salek
keywords: Esophageal carcinoma; neoadjuvant chemoradiation; survival