Impact of Radiotherapy, Chemotherapy and Surgery in Multimodal Treatment of Locally Advanced Esophageal Cancer

Objectives: It was the aim of this study to assess our
institutional experience with definitive chemoradiation (CRT)
versus induction chemotherapy followed by CRT with or without
surgery (C-CRT/S) in esophageal cancer. Methods: We retrospectively
analyzed 129 institutional patients with locally advanced
esophageal cancer who had been treated by either CRT in analogy to
the RTOG 8501 trial (n = 78) or C-CRT/S (n = 51). Results: The
median, 2-and 5-year overall survival (OS) of the entire collective
was 17.6 months, 42 and 24%, respectively, without a significant
difference between the CRT and C-CRT/S groups. In C-CRT/S patients,
surgery statistically improved the locoregional control (LRC) rates
(2-year LRC 73.6 vs. 21.2%; p = 0.003); however, this was
translated only into a trend towards improved OS (p = 0.084). The
impact of escalated radiation doses (>= 60.0 vs.