Pre-surgery Therapy Improves Survival for Esophagus Cancer PatientsJul 24, 2012
A study from the Netherlands shows that treating esophagus cancer patients with chemotherapy and radiation before surgery improves their survival. Preoperative chemo and radiation was already being used in many cases to try to shrink the cancer and make it easier to remove. This large, randomized trial is significant because it provides evidence that this strategy also helps patients live longer.
In the study, published in the New England Journal of Medicine, 366 people with operable esophagus cancer were randomly assigned to receive either surgery alone, or surgery after chemotherapy and radiation. Patients in the chemo-radiation group lived an average of about 4 years, compared to about 2 years in the patients who got surgery alone. About 3 in 10 patients in the chemo-radiation group had no signs of any cancer remaining when their surgery samples were looked at under a microscope.
All of the participants in the study were able to be treated with surgery. But more than half of patients diagnosed with esophagus cancer are not eligible for surgery because they are not healthy enough, or because the cancer has spread outside of the esophagus. In these cases, chemo and radiation may be used as the main treatment.
Even when surgery is an option, removing cancer from the area around the esophagus is difficult, because it’s so close to many other organs in the body. This often results in tumor cells being left behind after surgery. Getting chemotherapy and radiation before surgery improves the chance of removing all the tumor cells with surgery. The combo is sometimes also given to patients after surgery to try to kill any remaining tumor cells.
Learn more about treating esophagus cancer in our Esophagus Cancer Detailed Guide.
Preoperative Chemoradiotherapy for Esophageal or Junctional Cancer. Published in the May 31, 2012 issue of the New England Journal of Medicine. First author: Pieter van Hagen, MD, Erasmus University Medical Center, the Netherlands.