Route 66 for Esophageal Cancer

Esophageal cancer treatment with chemoradiotherapy before surgery extends life

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) If you wanted to go cross country back in the 1930s, you'd probably travel via America's iconic Route 66 -- from Chicago to Los Angeles. It was a cool way to go. Recent research has discovered an excellent treatment route for people with esophageal cancer.

Having chemotherapy and radiation before surgery is twice as likely to extend the road for folks with esophageal cancer than having surgery alone.

"Ask questions. Research. Learn about the best ways to treat the cancer."

Pieter van Hagen, MD, of the University Medical Center/Daniel den Hoed Cancer Center in Rotterdam, the Netherlands, led a study involving 366 people with esophageal cancer. The vast majority of participants -- 275 -- had adenocarcinoma, the most common and fastest growing type of esophageal cancer. 

Individuals were randomly assigned to receive either chemotherapy and radiation followed by surgery, or surgery alone. The study was designed to measure the impact of these two treatment plans.

"This large, randomized trial of neoadjuvant chemoradiotherapy in patients with esophageal or esophagogastric-junction cancer showed significantly better overall and disease-free survival among patients who received a chemoradiotherapy regimen based on carboplatin and paclitaxel, followed by surgery, as compared with those treated with surgery alone," the authors wrote.

Surgeons were able to remove the tumors -- leaving clean (no cancer) margins -- in 92 percent of the people who received both chemotherapy and radiation, compared to 69 percent in the surgery alone group. 

Total remission was seen in 47 of 161 patients (29 percent) who underwent surgery after chemoradiotherapy. 

The median (in the middle) time the patients lived was 49.4 months in the chemoradiotherapy-surgery group, as opposed to 24.0 months in the surgery group.

"Preoperative chemoradiotherapy improved survival among patients with potentially curable esophageal or esophagogastric-junction cancer," the authors conclude.

This research was published May 31, 2012 in the New England Journal of Medicine.

The study was funded by the Dutch Cancer Foundation. Conflicts of interest disclosures were not readily available.

Reviewed by: 
Review Date: 
June 14, 2012
Last Updated:
October 24, 2012