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Title: Adenocarcinoma of the esophagus and esophago-gastric junction: The effects of single and combined modalities on the survival and patterns of failure following treatment

Abstract

One hundred sixty-five patients with localized adenocarcinomas of the esophagus or esophago-gastric (EG) junction were treated with surgery alone, radiation therapy alone, chemotherapy alone, surgery followed by post-operative radiation therapy, chemotherapy, or chemosensitized radiation therapy, and chemosensitized radiation therapy alone. Patients were retrospectively evaluated for survival, control of tumor within the mediastinum, post-operative swallowing function, patterns of failure, and treatment-related morbidity. Follow-up of survivors ranges from 9-88 months (median 23 months). Chemotherapy and radiation therapy as single modalities were associated with a recurrence rate of 100%. Combined modality therapy significantly reduced the risk of local recurrence in all patient groups. Chemosensitized radiation therapy alone reduced the local recurrence rate to 48%, and surgery followed by radiation therapy reduced the local failure rate to 24%. When chemotherapy or chemosensitization was added to surgery plus radiation, the risk was further reduced to 15%. The use of combined modality therapy was also found to extend the survival of patients without excessive toxicity. Median survival was shortest among the group treated with radiation alone (5 months) and intermediate among patients following chemosensitized radiation alone (10 months) or complete surgical resection alone (15 months). Patients treated with all three modalities had the longest median survivalmore » (21 months). Based on this experience, the optimum treatment of these patients appears to include aggressive attempts at surgical resection with chemosensitized radiation therapy. Excellent pallination can also be achieved in unresectable patients with chemosensitized radiation therapy with a smaller chance for long term survival.« less

Authors:
; ; ; ;  [1]
  1. Univ. of Pennsylvania School of Medicine (USA)
Publication Date:
OSTI Identifier:
6069364
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics; (USA)
Additional Journal Information:
Journal Volume: 19:3; Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; COMBINED THERAPY; ESOPHAGUS; PATIENTS; STOMACH; SURGERY; SURVIVAL CURVES; BODY; DIGESTIVE SYSTEM; DISEASES; GASTROINTESTINAL TRACT; MEDICINE; NEOPLASMS; ORGANS; THERAPY; 550603* - Medicine- External Radiation in Therapy- (1980-); 550600 - Medicine

Citation Formats

Whittington, R, Coia, L R, Haller, D G, Rubenstein, J H, and Rosato, E F. Adenocarcinoma of the esophagus and esophago-gastric junction: The effects of single and combined modalities on the survival and patterns of failure following treatment. United States: N. p., 1990. Web. doi:10.1016/0360-3016(90)90485-3.
Whittington, R, Coia, L R, Haller, D G, Rubenstein, J H, & Rosato, E F. Adenocarcinoma of the esophagus and esophago-gastric junction: The effects of single and combined modalities on the survival and patterns of failure following treatment. United States. https://doi.org/10.1016/0360-3016(90)90485-3
Whittington, R, Coia, L R, Haller, D G, Rubenstein, J H, and Rosato, E F. 1990. "Adenocarcinoma of the esophagus and esophago-gastric junction: The effects of single and combined modalities on the survival and patterns of failure following treatment". United States. https://doi.org/10.1016/0360-3016(90)90485-3.
@article{osti_6069364,
title = {Adenocarcinoma of the esophagus and esophago-gastric junction: The effects of single and combined modalities on the survival and patterns of failure following treatment},
author = {Whittington, R and Coia, L R and Haller, D G and Rubenstein, J H and Rosato, E F},
abstractNote = {One hundred sixty-five patients with localized adenocarcinomas of the esophagus or esophago-gastric (EG) junction were treated with surgery alone, radiation therapy alone, chemotherapy alone, surgery followed by post-operative radiation therapy, chemotherapy, or chemosensitized radiation therapy, and chemosensitized radiation therapy alone. Patients were retrospectively evaluated for survival, control of tumor within the mediastinum, post-operative swallowing function, patterns of failure, and treatment-related morbidity. Follow-up of survivors ranges from 9-88 months (median 23 months). Chemotherapy and radiation therapy as single modalities were associated with a recurrence rate of 100%. Combined modality therapy significantly reduced the risk of local recurrence in all patient groups. Chemosensitized radiation therapy alone reduced the local recurrence rate to 48%, and surgery followed by radiation therapy reduced the local failure rate to 24%. When chemotherapy or chemosensitization was added to surgery plus radiation, the risk was further reduced to 15%. The use of combined modality therapy was also found to extend the survival of patients without excessive toxicity. Median survival was shortest among the group treated with radiation alone (5 months) and intermediate among patients following chemosensitized radiation alone (10 months) or complete surgical resection alone (15 months). Patients treated with all three modalities had the longest median survival (21 months). Based on this experience, the optimum treatment of these patients appears to include aggressive attempts at surgical resection with chemosensitized radiation therapy. Excellent pallination can also be achieved in unresectable patients with chemosensitized radiation therapy with a smaller chance for long term survival.},
doi = {10.1016/0360-3016(90)90485-3},
url = {https://www.osti.gov/biblio/6069364}, journal = {International Journal of Radiation Oncology, Biology and Physics; (USA)},
issn = {0360-3016},
number = ,
volume = 19:3,
place = {United States},
year = {Sat Sep 01 00:00:00 EDT 1990},
month = {Sat Sep 01 00:00:00 EDT 1990}
}