[Role of an exclusive concomitant radio-chemotherapy treatment in non operable esophageal cancer: results of a 10-year experience in Antoine-Lacassagne Center].

Treatment of non operable esophageal cancer still remains debatable. To date, radio-chemotherapy treatment could be considered as a standard, offers to the patients real hope and a new area of management in this unfavourable cancer. The aim of the present study was to report retrospectively a 10 year experience in concomitant radio-chemotherapy primary treatment in non operable esophageal cancer patients in Antoine Lacassagne anti cancer Center. Between January 1989 and June 1997, 63 consecutive, previously untreated patients with squamous cell carcinoma of the esophagus and who were inoperable for various reasons were majoritably treated with cisplatin (70 mg/m2) at J1 plus 5-fluorouracil (800 mg/m2/d) from J1 to J5 every 3 weeks (78% of patients) concomitantly with external beam radiotherapy (2 types). Two other chemotherapy regimens has been also used. Seventy-five percent (47/63) of the patients received the stipuled concomitant radio-chemotherapy dose. Neutropenia in the form of WHO grade 3-4 : 27% (17/63) was observed, grade 3-4 anemia and thrombopenia in 16 (26 %) and in 9 (15%) patients, respectively, grade 3-4 emesis in 6 % (4/63), grade 3-4 mucositis in 10 % (6/63). On 47 patients with accessible responder status, 18 of them presented a complete response, 20 a partial response, 6 a stable disease and 3 a progressive disease. The median follow up was 7 years. The median overall survival was 9.6 months with 11% estimated to be alive after 5 years. Combined treatment with cisplatin 5-fluorouracil and radiotherapy for inoperable cancer of the esophageal is relatively well tolerated and reasonably efficacious in a very selected group of patients.