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Burmeister BH, Dickie G, Smithers BM, Hodge R, Morton K. Thirty-four Patients With Carcinoma of the Cervical Esophagus Treated With Chemoradiation Therapy. Arch Otolaryngol Head Neck Surg. 2000;126(2):205–208. doi:10.1001/archotol.126.2.205
To review the experience of 2 institutions in the management of localized carcinoma of the cervical esophagus with chemoradiation therapy.
A series of 34 patients received chemoradiation therapy for a 5-year period. All patients were treated with curative intent. Three different regimens were used, all involving concomitant chemotherapy and high-dose radiation therapy. Data relating to toxic effects, local control of disease, and disease-free and overall survival were prospectively collected.
Two combined clinics at separate major hospitals where multidisciplinary care is the standard practice for this disease.
Patients with biopsy-proved carcinoma of the cervical esophagus.
Patients received 3 different chemotherapy regimens. Two of the regimens used a combination of cisplatin and fluorouracil. The high-dose cisplatin regimen was a large dose of cisplatin (80 mg/m2) given on days 1 and 22 followed by a 96-hour infusion of fluorouracil (800 mg/m2) from days 2 to 5 and from days 23 to 26. The low-dose cisplatin regimen was cisplatin, 20 mg/m2, from days 1 to 5 and from days 22 to 26 and the same 96-hour infusion of fluorouracil. The third regimen used fluorouracil alone. The mean radiation dose administered was 61.2 Gy in 29.6 fractions during 41.8 days using 4- or 6-mV photons and a shrinking field technique.
The results of treatment have shown a high rate of local control, although some patients developed metastases. The local complete response rate following treatment was 91%, and the rate of local control of disease was 88%. The projected actuarial 5-year survival rate was 55%. Death from other causes was common. The acute toxic effects of the treatment were acceptable, with only 5 patients requiring nasogastric feeding or gavage. Two patients died of complications related to strictures.
Concomitant chemoradiation therapy should be the treatment of choice for carcinoma of the cervical esophagus.
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