SUEYOSHI Susumu Kurume University, School of Medicine, Assistant professor, 医学部, 助教授 (30235840)
TANAKA Toshiaki Kurume University, School of Medicine, Lecturer, 医学部, 講師 (20227151)
TANAKA Yuichi Kurume University, School of Medicine, Assistant, 医学部, 助手 (50268900)
SASAHARA Hiroko Kurume University, School of Medicine, Assistant, 医学部, 助手 (10279185)
SUZUKI Gen Kurume University, School of Medicine, Assistant, 医学部, 助手 (80279182)
田中 健 久留米大学, 医学部, 講師 (60217023)
|Budget Amount *help
¥3,500,000 (Direct Cost: ¥3,500,000)
Fiscal Year 2006: ¥1,100,000 (Direct Cost: ¥1,100,000)
Fiscal Year 2005: ¥800,000 (Direct Cost: ¥800,000)
Fiscal Year 2004: ¥700,000 (Direct Cost: ¥700,000)
Fiscal Year 2003: ¥900,000 (Direct Cost: ¥900,000)
Purpose : To compare the outcomes after esophagectomy versus those after chemoradiotherapy for potentially respectable (T2-3,NO-1,MO) esophageal cancer
1) squamous cell carcinoma in the thoracic esophagus
2) potentially respectable cancer, cT2-3, cNO-1, cMO, cStage II-III
3) patients at a low risk for both esophagectomy and definitive chemoradiotherapy
4) no double primary cancers
5) obtaining informed consent
Methods : Patients choose one arm among the following three treatment arms after informed consent.
1) esophagectomy (S)
2) definitive chemoradiotherapy (CRT)
3) neoadjuvant chemoradiotherapy (NA) ; Patients choose surgery or non-surgical treatment after being informing of the response to the neoadjuvant chemoradiotherapy
Results : A hundred and two patients participated in this trial, from 2003 to 2006. There were 76 patients in the esophagectomy (S) group, 18 in the definitive chemoradiotherapy (CRT) group, and 8 in the neoadjuvant chemoradiotherapy (NA) group.
1) S Group : There
were 59 patients who underwent Ro resection, 16 who underwent R1R2 resection, and one who underwent only exploratory thoracotomy. The 1-, 2-, and 3-year-survival rate was 81%, 56%, and 49%, respectively in the S Group.
2) CRT Group : There were 14 patients with complete response, and 4 with incomplete response. There was no patient who underwent salvage surgery. The 1-, 2-, and 3-year-survival rate was 89%, 68%, and 46%, respectively in the CRT Group.
3) NA Group : There were three patients who underwent esophagectomy, and five who did not. The 1-, and 2-year-survival rate was 50% and 50%, respectively in the NA Group.
The 1-, 2-, and 3-year-survival rate was 81%, 56%, and 49%, respectively in those patients who chose the surgical treatment at first, and was 74%, 60%, and 40%, respectively in those patients who chose the non-surgical treatment at first (the CRT Group + the NA Group)
Conclusions : The outcomes after chemoradiotherapy for potentially respectable (T2-3,NO-1,MO) esophageal cancer may be similar to those after surgery. Less