We have performed a review of recent literature about combined modality therapy in esophageal cancer. Radiobiological principles and radio-chemotherapy interactions modalities in clinical experiences have been considered. Therapeutic schedules, modalities of implementation, and the most relevant clinical results obtained by the major clinical research groups have been emphasized. We also comment on the current role of surgery and on the clinical questions arising in combined radio-chemotherapy treatment.
Al SarrafM., MartzK., HerskovicA., LeichmanL., BrindleJ.S., VaitkeviciusV.K.: Superiority of chemoradiotherapy (CT+ RT) vs. radiotherapy (RT) in patients with esophageal cancer. Final report of the intergroup randomized and confirmed study.Proc. ASCO,15: 206, Abstr. 464, 1996.
2.
Al SarrafM., MartzK., HerskovicA., LeichmanL., BrindleJ.S., VaitkeviciusV.K., CooperJ., ByrhardtR., DavisL., EmamiB.: Progress report of combined chemoradiotherapy vs. radiotherapy alone in patients with esophageal cancer: an intergroup study.J. Clin. Oncol.,15: 277–284, 1997.
3.
AndoN., OzawaS., MikiA., SuwaT., KitajimaM.: Neoadjuvant chemotherapy and chemoradiotherapy in the treatment of esophageal cancer.Gan to Kagaku Ryoho,22: 1878–1885, 1995.
4.
BatesB.A., DetterbackF.C., BernardS.A., QaqishB.F., TepperJ.E.: Concurrent radiation therapy and chemotherapy followed by esophagectomy for localized esophageal carcinoma.J. Clin. Oncol.14: 156–163, 1996.
CoiaL., EngstromP., PaulA., StaffordP.M., HanksG.E.: Long term results of infusional 5FU, mitomycin C and radiation as a primary management of esophageal cancer.Int. J. Radiat. Oncol. Biol. Phys.,20: 29–36, 1991.
8.
EarleJ.D., GelberR.D., MertelC.G.: A controlled evaluation of combined radiation and bleomycin therapy for squamous cell carcinoma of the esophagus.Int. J. Radiat. Oncol. Biol. Phys.,6: 821–826, 1980.
9.
ErbieN., KangH.J., MillikanK., MurthyA.K., GriemK., HartsellW., RecineD.C., DoolasA., TylorS.: Integration of surgery in multimodality therapy for esophageal cancer.Am. J. Clin. Oncol.,20: 11–15, 1997.
10.
ForastiereA.A., OrringerM.B., Perez-TamayoC., UrbaS.G., HustedS., TakasugiB.J., ZahurakM.: Concurrent chemotherapy and radiation therapy followed by transhiatal esophagectomy for local regional cancer of the esophagus.J. Clin. Oncol.,8: 119–127, 1990.
11.
ForastiereA.A., OrringerM.B., Perez-TamayoC., UrbaS.G., ZahurakM.: Preoperative chemoradiation followed by transhiatal esophagectomy for carcinoma of the esophagus.Final report. J. Clin. Oncol.,11: 1118–1123, 1993.
FuK.K.: Biological basis for the interaction of chemotherapeutic agents and radiation therapy.Cancer,55: 2123–2130, 1985.
14.
HerskovicA., MartzK., Al SarrafM., LeichmanL., BrindleJ., VaitkeviciusV.K., CooperJ., ByrhardtR., DavisL., EmamiB.: Combined chemotherapy and radiotherapy compared with radiotherapy alone in patients with cancer of the esophagus.New Eng. J. Med.,326: 1593–1598, 1992.
15.
HoffmanP., FergusonM., HarafD.: Neoadjuvant chemotherapy, surgery and concomitant radiotherapy for carcinoma of the esophagus.Proc. ASCO,15: A457, 1996.
16.
IshidaK., IzukaT., AndoN., IdeH.: Phase II study of chemo-radiotherapy for advanced squamous cell carcinoma of the thoracic esophagus: nine japanese institutions trial.Jpn. J. Clin. Oncol.,26/5: 310–315, 1996.
17.
KagamiY., NishioM., NarimatsuN., MyoujinM., SakuraiT., HareyamaM.: Treatment of squamous cell carcinoma of the esophagus with alternating radiotherapy and chemotherapy (cisplatin, methotrexate and peplomycin).Am. J. Clin. Oncol.,20: 16–18, 1997.
18.
KnoxR.J., FriedlosF., LydallD.A.: Mechanisms of cytotoxicity of anticancer platinum drugs: evidence that cis-diammine-dichloro-platinum (II) and cis-diammine 1,1 ciclobutane-dicarboxylate-platinum (II) differ only in the kinetics of their interaction with DNA.Cancer. Res.,46: 1972–1979, 1986.
19.
LackeyV.L., ReaganM.T., SmithA., AndersonW.J.: Neoadjuvant therapy of squamous cell carcinoma of the esophagus: role of resection and benefit in partial responders.Ann. Thorac. Surg.,48: 218–225, 1989.
20.
LawrenceT.S., MaybaumJ.: Fluoropyrimidines as radiation sensitizers.Sem. Rad. Oncol.,13: 20–28, 1993.
21.
LeichmanL., SteigerZ., SeydelH.G., DindogruA., KinzieJ., TobenS., MacKenzieG., ShellJ.: Preoperative chemotherapy and radiation therapy for patients with cancer of the esophagus: a potentially curative approach.J. Clin. Oncol.,2: 75–79, 1984.
22.
LeichmanL., HerskovicA., LeichmanC.G., LattinP.B., SteigerZ., TapazoglouE., RosenbergJ.C., ArbuluA., AsfawI., KienzeJ.: Non operative therapy for squamous cell cancer of the esophagus.J. Clin. Oncol.,5: 365–370, 1987.
23.
LeichmanL.: Cancer of the esophagus: the Wayne State University experience.Invest. New Drugs,7: 91–98, 1989.
24.
LooneyW.B., HopkinsH.A.: Alternation chemotherapy in cancer management.Cancer Treat. Rep.,70: 141–162, 1986.
25.
MacFarlaneS.D., HillL.D., JollyP.C., KozarekR.A., AndersonR.P.: Improved results of surgical treatment of esophageal and gastroesophageal junction carcinomas after preoperative combined chemotherapy and radiation.J. Thorac. Cardiovasc. Surg.,95: 415–421, 1988.
26.
MalhaireJ.P., LabatJ.P., Lozac'hP., SimonH., LucasB., TopartP., VolantA.: Preoperative concomitant radiochemotherapy in squamous cell carcinoma of the esophagus: results of study of 56 patients.Int. J. Radiat. Oncol. Biol. Phys.,34: 429–437, 1996.
27.
MastersG.A., HarrafD.J., HoffmanP.C., GolombH.M., VolkesE.E.: Phase I study of concomitant docetaxel (Taxotere, TXT) and radiation in advanced chest malignancies.Proc. ASCO,15: A1112, 1996.
28.
PoplinF., FlemingT., LeichmanL., SeydelG.: Combined therapies for squamous cell carcinoma of the esophagus, a South West Oncology Group study (SWOG 8037).J. Clin. Oncol.,5: 622–628, 1987.
29.
RichmondJ., SeydelH.G., BaeY., LewisJ., BurdakinJ., JacobsenG.: Comparison of three treatment strategies for esophageal cancer within a single institution.Int. J. Radiat. Oncol. Biol. Phys.,13: 1617–1622, 1987.
30.
RockwellS.: Cytotoxicities of mitomycin C and X-rays to aerobic and hypoxic cells in vitro.Int. J. Radiat. Oncol. Biol. Phys.,8: 1035–1039, 1982.
31.
RothJ.A., PutnamJ.B., RichT.A., ForastiereA.A.: Cancer of the esophagus. In: Principles and practice of oncology, DeVitaV.T., HellmanS., RosenbergS.A., pp. 980–1015, JB Lippincott Co., Philadelphia, 1997.
32.
RousselA., BleibergH., DalesioO., JacobJ.H., HaegelP., JungG.M., PaillotB., HeintzJ.F., GignouxM., NascaS., NamerA., BuyseM., DuezM.: Palliative therapy of inoperable oesophageal carcinoma with radiotherapy and methotrexate: final results of controlled clinical trial.Int. J. Radiat. Oncol. Biol. Phys.,16: 67–72, 1989.
33.
SafranH., KingT., HeskethP., FriedmanS., SikovW., KwakwaH., MaskoG., HansonL., WeymanA., RosmarinA.: Phase II study of neoadjuvant paclitaxel, cisplatin and radiation followed by esophagectomy for esophageal carcinoma.Proc. ASCO,15: A513, 1996.
34.
SichyB., RyanL., HallerD., SmithT., DayalY., SchuttA.: Interim report of EST 1282 phase III protocol for the evaluation of combined modalities of the treatment of patients with carcinoma of the esophagus. Stage I and II (Abstract).Proc. ASCO,9: 105, 1990
35.
SinclairW.K.: The combined effect of hydroxyurea and X-rays on Chinese hamster cells in vitro.Cancer Res.,28: 198–206, 1968.
36.
SthalM., WilkeH., FinkU., StuschkeM., WalzM.K., SiewertJ.R., MollsM., FeetW., MakoskiH., BreuerN.: Combined preoperative chemotherapy and radiotherapy in patients with locally advanced esophageal cancer. Interim analysis of the Phase II trial.J. Clin. Oncol.,14: 829–837, 1996.
SteelG.G., PeckamM.J.: Exploitable mechanisms in combined radiotherapy-chemotherapy: additivity.Int. J. Radiat. Oncol. Biol. Phys.,5: 85–89, 1979.
39.
SteelG.G.: Terminology in description of drug radiation interactions.Int. J. Radiat. Oncol. Biol. Phys.,5: 1145–1150, 1979.
40.
SwisherS.G., HolmesE.C., HuntK.K., DotyJ.E., ZinnerM.J., McFaddenD.W.: The role of neoadjuvant therapy in surgically resectable esophageal cancer.Arch. Surg.,131: 819–825, 1996.
41.
TanabeM.: Effects of fractionated schedules of irradiation combined with cis-diamine-dichloro-platinum of the SCCVII-ST tumor and normal tissue of the C3H-KM mouse.Int. J. Radiat. Oncol. Biol. Phys.,13: 1523–1530, 1987.
42.
TannockI.F., RotinD.: Keynote address: mechanisms of interaction between radiation and drug with potention for improvement in therapy.NCI Monography,6: 77–83, 1988.
43.
TannockI.F.: Treatment of cancer with radiation and drugs.J. Clin. Oncol.,14: 3156–3174, 1996.
44.
TrottK.R.: Radiation-chemotherapy interactions.Int. J. Radiat. Oncol. Biol. Phys.,12: 1409–1413, 1986.
45.
TubianaM., ArriagadaR., CossettJ.M.: Sequencing drugs and radiation.Cancer,55: 2131–2139, 1985.
46.
VolkesE.E., WeichselbaumR.R.: Concomitant chemoradiotherapy: rationale and clinical experience in patients with solid tumors.J. Clin. Oncol.,8: 911–934, 1990.
47.
Von der MasieH.: Experimental studies of interactions of radiotherapy and cancer chemotherapy in normal tissue and a solid tumor.Radiother. Oncol.,7: 47–53, 1987.
48.
WeichselbaumR.R.: The role of DNA repair processes in the response of human tumors to fractionation radiotherapy.Int. J. Radiat. Oncol. Biol. Phys.,110: 112–124, 1984.
49.
WilsonK.S., LimJ.T.: Esophageal cancer: preliminary report of primary chemotherapy + radiotherapy and surgery for incomplete responders.Proc. ASCO,15: A523, 1996.
50.
WodinskyI., SwimarskyJ., KenslerC.J.: Combination radiotherapy and chemotherapy for P388 lymphocytic leukemia in vivo.Cancer ChemotHer. Rep.,4: 73–80, 1974.
51.
YuL., VikramB., MalamudD., YudelmanI., NussbaumM., BeattieE.: Chemotherapy rapidly alternating with twice a day accelerated radiation therapy in carcinoma involving the hypopharynx or esophagus: an update.Cancer Invest.,13: 567–572, 1995.