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Gastroenterology (Expert Forum)
Chemoradiotherapy for Esophageal Cancer
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Chemoradiotherapy for Esophageal Cancer
by rick__0, Jul 31, 1998 12:00AM
My relative has been diagnosed with esophageal cancer on Tuesday.
She appears to be T3N1M0, Stage III based on CT of abdomen and chest.
Squamous cell carcinoma was found on biopsy after endoscopy.
The tumor appears to be relatively large and may have entered the larynx,
we are waiting for a neck CT scheduled for Monday.
Because of the size/location of the tumor, we were advised that it is not operable at this time.
Chemoradiotherapy is being recommended. My question is what are the statistics on the various chemo cocktails.
The oncologist has recommended CDDP, 5-FU.
This is consistent with the Wayne State protocol.
Are the indications from ongoing studies that other chemo combinations are more effective with similar toxicity levels?
Thanks for your prompt reply.
_____________
Dear Rick,
I am sorry to hear about your relative's tumor. Carcinoma of the esophagus with lymph node involvement is a very serious condition.
Chemotherapy with cisplatin (CDDP) and 5-FU in combination with radiotherapy and/or surgery has been the cornerstone of therapy. Your relative is not a surgical candidate, because the entire tumor probably is not resectable. In this situation, palliative therapy with this chemo regimen in combination with radiotherapy should be considered.
You have asked us about other chemotherapeutic regimens. At present all available regimens utilize cisplatin and 5-FU. A new regimen adding a drug called paclitaxel is currently being evaluated. This regimen utilizes paclitaxel, 5-FU and cisplatin in patients with unresectable esophageal cancer. The initial study suggests that the duration of response is about six months. Survival rates vary from 1.5 months to 25 months. Unfortunately, about half of the patients required hospitalization for toxicity from the treatment. This new regimen could be considered for second line therapy if she does not respond to the initial regimen.
When considering treatment of advanced esophageal carcinoma it is important to maintain a balance between quality of remaining life and aggressiveness of therapy. I suggest that you meet with your oncologist and plan out a treatment regimen that would give your relative maximum quality of life.
This informationis presented for educational purposes only. Always consult your personal physician for specific medical questions.
HFHSM.D.-sg
*keywords: esophageal cancer
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