A Case of Complete Remission to Advanced Esophageal Cancer by a Concurrent Chemoradiation Therapy

Kang, Chang Moo; Kim, Jong Kwan; Kim, Choong Bai

Abstract

Esophageal cancer is still a virulent disease that leads to death. Surgery has been regarded as the treatment of choice in patients suffering this type of cancer and recent improvements in surgical techniques and perioperative management have significantly increased the resection rate and reduced the operative mortality. Nevertheless, long-term survival rates remain poor. The poor prognosis reflects the fact that the disease is usually advanced at the time of diagnosis. Therefore, a combination of chemotherapy and radiotherapy has recently been developed as a treatment for advanced esophageal cancer patients. Chemoradiation therapy is based on the concept of the biochemical modulation effects and radiosensitizing effects of the chemotherapeutic agents. How ever, the optimal choice of chemotherapeutic agents and their doses, as well as the chemotherapy and radiotherapy regimens have not been precisely established. We report a case of concurrent chemoradiation protocol by which a complete response was achieved. 5-FU (1,800 mg/body/day) was continuously infused over 24 hours and cisplatin (45 mg/ body/day) was administered 1 hour before radiotherapy for 3 days. This chemotherapy course was repeated once more after 4 weeks. The radiotherapy (180 cGy/day) was scheduled for 5 consecutive days, followed by a 2-day withdrawal, and a total dose of 5,940 cGy within 7 weeks. Our concurrent chemoradiation therapy is deemed rational, effective and safe because an endoscopically and pathologically complete response was achieved 1 year after chemoradiation therapy without any severe side effects. Therefore, we believe that our concurrent chemoradiation therapy can be recommended as a treatment for advanced esophageal cancer patients.