Neoadjuvant Chemoradiotherapy in Esophageal or Gastro-oesophageal Junction Cancer

Dr. Prema. K R; Dr. Shinto Rajappan; Dr. R. Mahadevan

Volume : VIII, Issue : I, January - 2019

Neoadjuvant Chemoradiotherapy in Esophageal or Gastro-oesophageal Junction Cancer

Dr. Prema. K R, Dr. Shinto Rajappan, Dr. R. Mahadevan

Abstract :

Background: Esophageal cancer is a serious malignancy with regard to mortality and prognosis. The incidence of squamous cell carcinoma is increasing in the developing countries and adenocarcinomas in the developed countries. Although modest improvements in survival have been achieved by combining neoadjuvant chemoradiation and surgery in resectable esophageal cancer, patients treated with chemoradiation alone or surgery alone have high locoregional relapse rate and high mortality rate. Materials and methods: A single arm prospective study was conducted at Government Medical College, Thrissur, India during the period 2013– 2015, with a total of 22 patients with primary resectable esophageal or esophagogastric junction cancers. The aim of the study was to assess the response of preoperative chemoradiation, and acute toxicities of this treatment. Results: Preoperative chemoradiation has resulted in downstaging of primary disease in 81.82% of patients with acceptable grade1 and grade 2 toxicities and minimum number of grade 3 toxicity during treatment. Pathological complete response in 22.7%, and moderate pathological response in 50% patients was obtained. Conclusion: Neoadjuvant concurrent chemoradiotherapy is found to be an effective modality of treatment in stage 2 and stage 3 esophageal cancer in terms of downstaging and further surgery, with acceptable toxicity, and also improving the quality of life after treatment, and improving the survival