Treatment for cancer of the esophagus, the tube that connects the throat to the stomach, usually includes surgery or radiation therapy. Researchers continue to search for more effective treatment strategies, including the use of chemotherapy with surgery and/or radiation therapy. Recently, researchers in the Radiation Oncology Study Group found that the use of radiation therapy with chemotherapy to treat localized cancer of the esophagus resulted in prolonged survival times over the use of radiation therapy alone.
The researchers treated a number of persons with localized cancer of the esophagus (cancer that has not spread outside the esophagus) with either radiation alone or radiation plus chemotherapy. After this study, they treated more persons who had localized squamous cell or adenocarcinoma types of cancer of the esophagus with both radiation therapy and chemotherapy. In total, 62 persons received radiation therapy alone and 134 persons received radiation plus chemotherapy with fluorouracil and cisplatin. These patients were followed for at least 5 years after treatment.
The findings showed that of those who received the chemotherapy and radiation in the first trial, 2% died of treatment-related side effects. No treatment-related deaths occurred in the group that received radiation therapy alone. Likewise, no treatment-related deaths occurred in the second group that received chemotherapy and radiation, perhaps due to improvements in supportive care that had occurred with time and experience. In the first trial, the average 5-year survival rates were 26% for the chemotherapy group and 0% for those who received radiation therapy alone. The survival rate after 8 years was 22%. Of the individuals who were treated after the first trial, the average 5-year survival rate for those receiving chemotherapy and radiation was 14%. The number of cancer recurrences was fewer in those who received the combined treatment regimen. After 5 years, no recurrences of cancer were observed.
The researchers concluded that the combination of chemotherapy and radiation therapy for persons with localized cancer of the esophagus resulted in improved survival times, compared with treatment with radiation therapy alone. Persons with this type of cancer may wish to talk with their doctor about the risks and benefits of participating in a clinical trial in which new combination chemotherapy and radiation therapy regimens are being studied. Sources of information on ongoing clinical trials that can be discussed with a doctor include a comprehensive, easy-to-use service provided by the National Cancer Institute (cancer.gov) and the Clinical Trials section and service offered by CancerConnect (cancerconnect.com). (Journal of the American Medical Society, Vol 281, No 17, pp 1623-1627, 1999)