Table 2

Randomized trials of preoperative radiotherapy (RT) and surgery versus surgery alone.

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


Launois et al. 1981 [21]

124 patients March 1973-June 1976 France, single centre, squamous cell

67

64 – 90 Gy preop RT + esophagectomy

4.5

46

20

15

14

10

perioperative mortality was 23% in both groups.

versus

versus

versus

versus

57

esophagectomy (left thoracotomy)

8.2 (mean)

50

35

25

20

12

p = NS, but NR

Gignoux et al. 1987 [22]

229 patients [dates not reported] EORTC, 8 centres, squamous cell, no cervical lesions, no previous cancer, no previous treatment.

115

33 Gy preop RT + esophagectomy

12.3

55

24

20

17

10

tracheosophageal fistula, 2; bleeding, 1; esophagitis, 1; respiratory deaths, 6

versus

versus

versus

versus

versus

114

esophagectomy

12 (mean)

57

30

14

11

9

respiratory deaths, 8

No difference in survival (p = 0.94), but RT may delay local recurrence

Wang et al. 1989 [23]

206 patients June 1977-May 1985 China, single centre histology not reported < 65 years age, < 8 cm length no metastases

104

40 Gy preop RT + esophagectomy

NR

-

-

-

-

35

leaks, 1; perioperative deaths, 5

versus

versus

versus

versus

versus

102

esophagectomy

NR

-

-

-

-

30

leaks, 5; perioperative deaths, 5

No difference in survival (p > 0.05).

Nygaard* 1992 [24]

108 patients Jan 1983-Jan 1988 Scandinavia, multi centre squamous cell < 75 years of age, Karnofsky score > 50, T1, T2, Nx, M0 > 21 cm from incisors

58

35 Gy preop RT + esophagectomy

10

44

25

21

-

-

respiratory, 5; leaks, 2; postoperative deaths, 4

versus

versus

versus

versus

versus

50

esophagectomy

7

34

13

9

-

-

respiratory, 5; leaks, 2; postoperative deaths, 5

No difference in survival (p = 0.08).

Arnott 1992 [25]

176 patients 1979–1983 Scotland, single centre < 80 years, squamous cell adenocarcinoma, distal 2/3 esophagus

90

20 Gy preop RT + esophagectomy

8

40

22

13

9

9

respiratory, 10; postoperative deaths, 10

versus

versus

versus

versus

versus

86

esophagectomy (left thoracoabdominal)

8

40

28

23

21

17

respiratory, 5; postoperative deaths, 8; surgical, 2

No difference in survival (p = 0.40).

Fok* 1994 [5]

79 patients 1968–1981 Hong Kong, single centre Squamous cell, middle 1/3 esophagus

40

24–53 Gy preop RT + esophagectomy

11

42

34

24

10

10

respiratory, 20; postoperative deaths, 12; leaks 11

versus

versus

versus

versus

versus

39

esophagectomy (right thoracotomy, left neck, and abdomen)

22

58

36

24

16

16

respiratory, 15; postoperative deaths, 3; leaks, 7

No difference in survival.


*Patients randomized to four groups; data shown are for radiotherapy + surgery versus surgery alone.

Note: EORTC, European Organization for Research and Treatment of Cancer.

Malthaner et al. BMC Medicine 2004 2:35   doi:10.1186/1741-7015-2-35

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