Skip to main content

Advertisement

Table 5 Randomized trials of preoperative chemotherapy (CT) and postoperative chemotherapy (CT) versus surgery alone.

From: Neoadjuvant or adjuvant therapy for resectable esophageal cancer: a systematic review and meta-analysis

Study, year [Reference] Participants Number of patients Interventions Median Survival (Months) Survival Rate (%) Adverse Effects (Number of Patients)
      1 yr 2 yr 3 yr 4 yr 5 yr  
Roth et al. 1988 [31] 39 patients 19 cisplatin 120 mg/m2 × 1 day × 1 cycle vindesine 3 mg/m2 × 4 days × 2 cycles bleomycin 10 U/m2 × 4 days × 2 cycles + esophagectomy + cisplatin 120 mg/m2 q 6 wks × 6 months + vindesine 3 mg/m2 q 12 wks × 6 months 9 50 28 28 - - alopecia, 17; vomiting, 2; pneumonia, 1; sepsis, 1; neurological, 1; respiratory failure, 1; renal, 1; leaks, 1; chylothorax, 3; pulmonary embolus, 1; wound infection, 1
  Nov 1982–May 1986 NCI, single centre squamous cell Stage I, II, III versus versus versus versus versus
   20 esophagectomy (transthoracic with cervical or thoracic anastomosis) 9 35 15 8 - - leaks, 3; chylothorax, 1; pulmonary embolus, 1; pneumonia, 1; strictures, 1; empyema, 1; subphrenic abscess, 1
      No difference in survival (p = 0.34). Survival advantage in responders and if less than 10% weight loss.  
Kelsen et al. 1998 [36] 467 patients Aug 1990 to Dec 1995 North America, multi-centered Resectable esophageal cancer 55% adenocarcinoma 45% squamous cell 233 cisplatin 100 mg/m2 × 1 day × 3 cycles 5-fluorouracil 1 g/m2 × 5 days × 3 cycles + esophagectomy + cisplatin 75 mg/m2 × 1 day × 2 cycles if responded 14.9 59 35 23 19 18 minor, 49; major, 53; toxic deaths, 9; neutropenia, 68; mucositis, 58; postoperative deaths, 10
   versus versus versus versus versus
   234 esophagectomy 16.1 60 37 26 21 20 minor, 67; major, 57; postoperative deaths, 13
      No survival difference.  
  1. Note: NCI, National Cancer Institute