Back to 31st Annual Meeting
Back to Program Outline

BACKGROUND: The efficacy of induction chemotherapy followed by concurrent chemoradiotherapy (CCRT) for patients with esophageal cancer has been demonstrated in previous phase II trials. CCRT has not been compared to traditional concurrent chemoradiotherapy (CRT).
METHODS: 247 patients with esophageal adenocarcinoma treated with either CCRT or CRT from January 1997 to September 2003 were analyzed. Primary outcomes included pathologic tumor response and survival.
RESULTS: 117 patients received CCRT and 130 received CRT before resection. CCRT resulted in a 64% tumor response rate compared to 51% in the CRT group (OR 1.73, p=0.035). Median and 3-year overall survival was 55 months and 59% in the CCRT group and 25 months and 41% in the CRT group (HR 0.69, p=0.041). Median and 3-year disease-free survival were 43 months and 54% in the CCRT group and 18 months and 36 % in the CRT group (HR 0.72, p=0.047). Subset analysis of patients with clinical stage III/IVa showed a median and 3-year overall survival of 51 months and 58% in the CCRT group and 20 months and 28% in the CRT group (HR 0.57, p= 0.019).
CONCLUSIONS: CCRT resulted in an increased tumor response as compared to traditional CRT in patients with esophageal adenocarcinoma. A trend towards higher overall and disease-free survival was observed in patients receiving CCRT. Patients with advanced esophageal cancer may derive the most benefit from CCRT.