Combination Therapy Improves Chances Of Surviving Esophageal Cancer

The standard treatment for esophageal cancer is surgery or radiation therapy, but neither one is very effective - only 5% to 10% of patients are alive five years after treatment - and this kind of cancer is therefore considered highly lethal. The new, multicenter study, published in the May 5 issue of the Journal of the American Medical Association, found that 22% of patients treated with a combination of chemotherapy and radiation survived at least eight years following treatment.

"This study strongly suggests that one acceptable standard of care for advanced esophageal cancer should be radiation and chemotherapy given at the same time," says Jay S. Cooper, M.D., FACR, Professor of Radiation Oncology at NYU School of Medicine.

"We now have data showing long-term survival with the combined treatment," says Dr. Cooper. "In the future we need to compare this combined therapy to surgery and we need to assess whether there is a feasible way of integrating all of these therapies for the betterment of patients," he adds.

The esophagus is the muscular hollow tube that connects the throat to the stomach. There are about 12,500 new cases of esophageal cancer annually in the United States, and men are three times more likely to get this cancer than women, according to the American Cancer Society. Moreover, African American men are at greatest risk of getting this cancer.

Cigarette smoking and long-term heavy drinking increase the risk of getting esophageal cancer and a recent study found that chronic heartburn also raises the risk substantially.

The new study, which involved many institutions, was under the direction of the National Cancer Institute. It followed a group of 129 patients who were originally treated between 1985 and 1990 with a combination of radiation and chemotherapy or radiation alone as part of a randomized clinical trial. Because the combined treatment was so obviously associated with longer survival, the trial was halted and all 73 patients who were subsequently enrolled received the combination therapy.

The combined therapy "significantly increased overall survival compared with radiation therapy alone," the new study concluded. Five years after the original treatment, 26% of the patients who received the combination treatment in the randomized part of the trial and 14% of those in the "nonrandomized" part were alive, compared to none of the patients who received radiation alone.