title: Management of Locally Advanced Carcinoma Oesophagus with Radiation/Chemoradiation: Single Institute Experience.
abstract: OBJECTIVE
  Oesophageal malignancy is the fourth commonest cancer which has a very poor outcome. In the management of oesophageal malignancy, radiation therapy is underutilized by many physicians due to feared complications though its role is well proven in literature. This study brings the role of radiation therapy in terms of loco-regional and distant relapse. This study characterizes demographic characteristics, treatment modality and the impact of these on recurrence-free survival of locally advanced carcinoma oesophagus.
  
  
  METHODS
  In a retrospective analysis over a period of 24 months, 28 patients diagnosed to have locally advanced oesophageal malignancy were included. Neoadjuvant chemotherapy was carried out in 4 patients and concurrent chemoradiotherapy in 18 patients. Among the 28 patients, 7 patients who were operable and fit underwent surgery 6-8 weeks after completion of the planned neoadjuvant therapy. All patients received concurrent chemoradiation for a period of 5 weeks with platinum and/or taxane-based chemotherapy.
  
  
  RESULTS
  With a median follow-up of 12 months, loco-regional recurrence and distant relapse were substantially less with 14 and 10 %, respectively. The Kaplan-Meier recurrence-free survival was 60 % at 24 months. All patients who had surgery as a part of the multimodality management were disease free at the last follow-up.
  
  
  CONCLUSIONS
  In locally advanced oesophageal malignancy, radiation therapy plays an important role in downsizing the tumour for operability or can also be utilized as the sole modality of management.
authors.affiliation: Christian Medical College and Hospital, Vellore, Tamil Nadu, India. damodar.dr@gmail.com.
authors.forename: Damodara
authors.initials: D
authors.lastname: Kumaran
authors.affiliation: Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: Subhashini
authors.initials: S
authors.lastname: John
authors.affiliation: Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Isiah
authors.affiliation: Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: Saikat
authors.initials: S
authors.lastname: Das
mesh_terms: D059248:Chemoradiotherapy; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies
keywords: Adenocarcinoma; Chemotherapy; Locally advanced; Oesophageal malignancy; Radiation therapy; Recurrence; Squamous cell carcinoma