Screening for cancer, 1995: An update

Abstract

Summary Background This study was designed to evaluate the feasibility of a neo-adjuvant combined chemo-radiotherapy in patients with localized squamous cell carcinoma of the esophagus. Patients and methods Forty-two patients with squamous cell carcinoma of the esophagus, stages II and HI (or stage I if considered to be poor candidates for immediate curative surgery), age less than 70 years and WHO performance status 0 to 2, were enrolled in a study of radiotherapy combined with chemotherapy, consisting of 2 (operated patients) or 3 (non-operated patients) courses of cisplatin, vindesine, mitomy-cin-C or cisplatin, vinblastine. Surgery was routinely proposed to patients. Results Thirty-seven patients (88%) received full pre-operative therapy. Of 30 patients responding to this pre-operative therapy, 12 had a third cycle of treatment and 15 had esophagectomy. Three of the operated patients had no pathological evidence of residual tumour. Median survival of all 42 patients is 11 months and the 2-year survival rate is 29%. There is no difference in survival among responding operated or non-operated patients. Our group represents 95% of all eligible cases of squamous cell carcinoma of the esophagus occurring in Geneva during the study period. Conclusion Our series gives a realistic view of the median survival of a population of patients eligible for neo-adjuvant therapy of esophageal cancer, and suggests that secondary surgery might not improve the patient survival. Furthermore, non-selected patients are at high risk for therapy-related death.