Clinical Gastroenterology Vol.28 No.3(1)

Theme Perspective for Chemotherapy in Gastrointestinal Malignancy Based on Current Evidence
Title Neo-adjuvant and Adjuvant Therapy for Esophageal Cancer
Publish Date 2013/03
Author Shuichi Hironaka Clinical Trial Promotion Department, Chiba Cancer Center
[ Summary ] Since the late 1970s in Western countries and Japan, preoperative chemotherapy and chemoradiotherapy have been investigated. Many randomized controlled trials have been conducted. Based on the results of these studies, preoperative chemoradiotherapy is regarded as the standard means of care for resectable esophageal cancer in the West except in the UK, including Scotland. Preoperative chemotherapy is the standard treatment in the UK and Scotland. In Japan, the Japan Clinical Oncology Group (JCOG) has reported on many randomized trials using preoperative or postoperative therapy. The last trial, JCOG9907, indicated survival benefits from preoperative chemotherapy compared to postoperative chemotherapy. Thus, preoperative chemotherapy has become the new standard of care for resectable esophageal cancer in Japan. However, a new question has arisen as to whether preoperative chemoradiotherapy or chemotherapy are preferable. In Japan, a new phase III trial by the JCOG, comparing preoperative chemoradiotherapy, to preoperative chemotherapy is now on-going.
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