| [ Summary ] |
Recent progress in chemoradiotherapy for esophageal cancer has provided superior survival rates, as compared to radiation alone and survival rates identical to those obtained with surgery alone. In the National Cancer Center Hospital East, no significant difference in overall survival was observed between surgery alone and definitive chemoradiotherapy in patients with T2-3M0 diseases. Even in patients with potentially unresectable (T4/M1a) diseases, chemoradiotherapy yielded a 5-years survival rate of 19%, which suggested that chemoradiotherapy may have a curative potential. Based on these results, chemoradiotherapy should be suggested to patients with potentially resectable esophageal cancer as a treatment modality, equivalent to surgery. Although several clinical trials of preoperative chemoradiotherapy, followed by surgery, have been parformed in western countries, the superiority of this combined modality to surgery alone, or to definitive chemoradiotherapy, has not as yet been elucidated.
More recently, new drugs including nedaplatin, taxane, irinotecan and molecular target agents have been developed and are being evaluated for esophageal cancer. These agents alone, as well as in combination with radiotherapy may improve survival rates. |