Pre-operative chemoradiation therapy in complex treatment of patients with locally advanced tumors of the thoracic esophagus

Abstract

The objective of this study was to evaluate the preliminary results of the complex treatment of patients with locally advanced tumors of the thoracic esophagus after pre-operative chemordiation therapy. Materials and methods. Men and women (n=26) over 18 years of age with histologically squamous cell carcinoma tumors T3-4aN0-3M0 of the thoracic esophagus were included in our study. In this group of patients we performed pre-operative chemotherapy: paklitaxel 175 mg/м2 first day; cisplatin 75 mg/м2 first day; leucovorin 50 mg 1-3 days; 5-ftoruracil 425 mg/м2 1-3 days or instead of leucovorin and 5-ftoruracil we used capecitabine 1500 mg/м2 1-14 days, every 3 weeks followed by chemoradiation therapy (РОД 2 Gy, СОД 44-46 Gy) with weekly used of chemotherapy. We analyzed the preliminary results of the complex treatment in terms of the severity of toxicity, therapeutic pathomorphosis and reduction in the tumor stage and the number of postoperative complications. R0-resections were performed in 24 (92%) patients. Microscopic manifestations of the tumor in the proximal margin of resection (R1) were detected only in 2 (8%) patients. Therapeutic pathomorphosis was studied in all 26 patients. In the histological study, 8 (31%) patients did not have tumor cells, which was regarded as the complete effect of chemotherapy in the preoperative period. Pathomorphosis of grade 3 was observed in 9 patients, which was 35%. Thus, the used strategy of preoperative chemotherapy and chemoradiotherapy is a promising direction in improving long-term treatment outcomes.

Keywords

• locally advanced tumors of the esophagus
• complex treatment of the esophagus cancer
• induction chemotherapy
• therapeutic (curative) pathomorphosis