This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Neoadjuvant chemoradiotherapy for operable oesophageal carcinoma: preliminary results from Sheffield. BJS 2001; 88: 477-478.
Published: 6th December 2002
Authors: I. McL. Welch, P. M. Fisher, C. J. Stoddard, A. Wyman
Background
Surgical resection is the mainstay of treatment for potentially curable oesophageal carcinoma but the long‐term survival rate remains 10–20 per cent. Neoadjuvant administration of chemoradiotherapy (NCR) may improve these values. In this study the authors reviewed their preliminary experience with NCR in Sheffield.
Method
Twenty‐five patients with potentially resectable oesophageal carcinoma embarked on a regimen of NCR, with resection planned 4–6 weeks later. Chemotherapy incorporated two cycles of intravenous cis‐platinum and 5‐fluorouracil with external‐beam radiotherapy administered synchronously (30–45 Gy).
Results
Twenty‐two of the 25 patients suffered side‐effects from NCR, including one death, and seven patients failed to complete NCR as planned. The median interval from diagnosis to surgery was 121 days. Twelve out of 24 patients had significant postoperative complications, including two deaths. Seven patients had a complete histological response to NCR (three out of 15 for adenocarcinoma, four out of nine for squamous carcinoma).
Conclusion
The complete histological response rate to NCR in these patients compares favourably with previous studies, as does the postoperative mortality, but this was at the expense of substantial morbidity and was associated with long delays from diagnosis to operation. At present it is not possible to predict which patients will respond favourably to NCR and whether they will benefit with improved survival. © 2001 British Journal of Surgery Society Ltd
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