Authors: | Ku, G. Y.; Ilson, D. H. |
Article Title: | Esophageal cancer: Adjuvant therapy |
Abstract: | In the United States, esophageal cancer is an uncommon but aggressive malignancy. Prior research has focused on the incorporation of chemotherapy and radiotherapy in both the pre- and postoperative setting. Both squamous cell and adenocarcinoma histologies have been treated in trials, with adenocarcinoma now the predominant histology seen in the United States. Although preoperative chemotherapy improves survival compared with surgery alone, the addition of concurrent radiotherapy to preoperative chemotherapy improves rates of curative resection, reduces local tumor recurrence, and achieves a significant rate of pathologic complete response. Combined preoperative chemoradiotherapy is the preferred preoperative strategy for locally advanced esophageal cancers in the United States. Definitive chemoradiotherapy alone appears to be equivalent in terms of overall survival compared with chemoradiotherapy followed by surgery in squamous cancers, although the addition of surgery after chemoradiotherapy may afford superior local control of disease. Postoperatively, survival is improved with postoperative chemotherapy and radiotherapy in adenocarcinoma of the gastroesophageal junction, if none has been delivered preoperatively. Ongoing research involves evaluating regimens with newer chemotherapeutic drugs, such as paclitaxel or irinotecan, as well as the incorporation of targeted molecular therapies. © 2007 Lippincott Williams & Wilkins. |
Keywords: | survival; cancer chemotherapy; cancer survival; survival analysis; cancer surgery; overall survival; clinical trial; neutropenia; review; postoperative period; bevacizumab; cisplatin; erlotinib; fluorouracil; multimodality cancer therapy; antineoplastic agents; united states; paclitaxel; adjuvant therapy; cancer adjuvant therapy; cancer radiotherapy; comparative study; postoperative care; chemotherapy, adjuvant; combined modality therapy; neoadjuvant therapy; methodology; antineoplastic agent; adenocarcinoma; carboplatin; multiple cycle treatment; bone marrow suppression; etoposide; esophagitis; mucosa inflammation; nausea; randomized controlled trial; radiotherapy; randomized controlled trials as topic; continuous infusion; cetuximab; histology; vinblastine; irinotecan; gastrointestinal toxicity; preoperative period; tumor recurrence; folinic acid; adjuvant chemotherapy; gefitinib; clinical research; epirubicin; vindesine; preoperative treatment; disease control; trastuzumab; mitomycin; oxaliplatin; esophageal adenocarcinoma; esophagus tumor; esophageal neoplasms; esophageal squamous cell carcinoma; lower esophagus sphincter; matuzumab; molecular therapy |
Journal Title: | The Cancer Journal |
Volume: | 13 |
Issue: | 3 |
ISSN: | 1528-9117 |
Publisher: | Lippincott Williams & Wilkins |
Date Published: | 2007-05-01 |
Start Page: | 162 |
End Page: | 167 |
Language: | English |
DOI: | 10.1097/PPO.0b013e318074dbe7 |
PUBMED: | 17620765 |
PROVIDER: | scopus |
DOI/URL: | |
Notes: | --- - "Cited By (since 1996): 4" - "Export Date: 17 November 2011" - "CODEN: CAJOC" - "Source: Scopus" |