Operation combined with preoperative radiochemotherapy on esophageal squamous carcinoma

Abstract

Objective To evaluate the effects of preoperative radiochemotherapy on pathological staging and prognosis in the patients with advanced esophageal squamous carcinoma(ESCC). Methods 1997-2007,477 patients with advanced ESCC were randomized into four groups:neoadjuvant chemothera-py, neoadjuvant radiotherapy, neoadjuvant radiochemotherapy, and surgery alone (control group). The tumor resection rate, pathological stage, treatment-related complication, and survival among groups were compared. Results The radical resection rate for the patients in radiotherapy and radiochemotherapy groups was increased in comparison with the control group (P ＜ 0.05). Their pathological stage after esophagectomy was regressed significandy than that of the control group (50.8% ,54.2% vs 0% ,P ＜0.05). The chemotherapy group showed significant improvement on resection rate and pathological staging compared with the control group. The treatment related complication in three neoadjuvant groups had no significant difference from that of the control group (P ＞ 0. 05). The 3-year survival rate of radiotherapy and radiochemotherapy groups were significantly higher than that of the control group(69.5% ,72.9% vs 53.4%, P ＜ 0.05). The 5-year survival rate of radiochemotherapy and radiotherapy groups were was high-er than that of the control group(P ＜ 0.05), meanwhile the 5-year survival rate of radiochemotherapy was higher than that of radiotherapy group, but no statistical difference (P ＞ 0. 05). Conclusion Preoperative radiochemotherapy seems to provide an efficient therapy in radical resection and survival of patients with advanced ESCC. Key words: Esophageal carcinoma; Radiochemotherapy; Pathological stage