Management of locally advanced carcinoma oesophagus with radiation chemoradiation Single Institute experience

Esophageal malignancy is the 4th commonest cancer which has a very poor outcome. In the management of esophageal malignancy, radiation therapy is under utilized by many physician due to feared complications though its role is well proven in literature. This study brings the role of radiation therapy in terms of loco-regional and distant relapse. This study characterizes demographic characteristics , treatment modality and the impact of these on recurrence free survival of locally advanced carcinoma esophagus. Ina retrospective analysis over a period of 2 years, 28 patients diagnosed to have locally advanced esophageal malignancy were included. Neoadjuvant chemotherapy was carried out in 4 patients and concurrent chemo radiotherapy in 18 patients. Among the 28 patients,7 patients who were operable and fit, underwent surgery 6 to 8 weeks after completion of the planned neoadjuvant therapy. All patients received concurrent chemo-radiation over a period of 5 weeks with platinum and or taxane based chemotherapy.With a median follow up of 9 months, loco-regional recurrence and distant relapse was substantially less with 14 and 10 respectively. The Kaplan Meier recurrence free survival was 60 at 2 years. All patients who had surgery as a part of the multimodality management were disease free at the last follow up. In locally advanced esophageal malignancy, radiation therapy plays an important role in downsizing the tumor for operability or can also be utilized as the sole modality of management.