Onkologie. 2009:3(3):177-180

The role of chemotherapy in the management of esophageal cancer

Milada Zemanová

Onkologická klinika 1. LF UK a VFN v Praze

The role of chemotherapy in the management of esophageal cancer is in combined modality treatment of localized disease and in

the palliation of metastasizing stages. Benefit of chemotherapy in metastatic disease is less clear in squamous cell cancer than in adenocarcinoma.

We treat the patients regardless age if they are in good performance status and have positive attitude to the treatment.

The combinations based on cisplatin and 5-fluorouracil are standard of care. Some data support the same chemotherapy regimen in

squamous cancer as well as in adenocarcinoma. New phase III trials documented benefit of combinations with docetaxel, oxaliplatin

and capecitabine. Neither preoperative nor adjuvant chemotherapy is beneficial in squamous cell carcinoma. In adenocarcinoma, 2–3

cycles of neoadjuvant chemotherapy or perioperative chemotherapy (3cycles pre- and 3 cycles postoperative treatment) prolong survival

comparing to surgery alone. Concurrent chemoradiotherapy prolongs 1-year survival in 10 % comparing to radiotherapy alone,

sequential chemo and radiotherapy is not beneficial. Neoadjuvant concurrent chemoradiotherapy has benefit for survival comparing

to surgery alone, but preoperative sequential chemoradiation has the same result as surgery.

Keywords: esophageal cancer, chemotherapy, chemoradiotherapy, neoadjuvant therapy.

Published: June 15, 2009  Show citation