Long‐term results of combined modality therapy for esophageal cancer

Published local control and survival rates strongly suggest the superiority of concurrent chemotherapy (CT) and radiotherapy (RT) over RT alone in the management of esophageal cancer, at least in the first 2–3 years after treatment. It is not yet known, however, if these promising early results will be sustained at 5 years and beyond. The present report updates a series that includes 103 patients with clinical stages I—III esophageal cancer treated with combined RT (44–64 Gy) and CT (5‐fluorouracil or etoposide plus cisplatin or carboplatin) either as definite therapy (n = 45) or as pre‐esophagectomy treatment (n = 58). Five year actuarial local control was 53% in the surgery group and 39% in the group without surgery (P < 0.01). Overall survival of both groups was 14% at 5 years. Late local failures and deaths beyond 3 years occurred in both groups. These results, combined with the few other series documenting 5 year outcomes, are not substantially different from 5 year results reported after RT alone. We conclude that extended follow‐up of 5 years or more is necessary before any combined modality regimen can be considered to be superior to single modality therapy for esophageal cancer. © 1993 Wiley‐Liss, Inc. Copyright © 1993 Wiley‐Liss, Inc., A Wiley Company

Duke Scholars

Author Jeffrey Crawford Medicine, Medical Oncology