Overview of different available chemotherapy regimens combined with radiotherapy for the neoadjuvant and definitive treatment of esophageal cancer

Expert Rev Clin Pharmacol. 2017 Jun;10(6):649-660. doi: 10.1080/17512433.2017.1313112. Epub 2017 Apr 10.

Abstract

Neoadjuvant chemoradiotherapy (CTRT) is the current standard of care for treatment of locally advanced cancer of the esophagus or gastroesophageal junction. Many efforts have been made over the last years to identify the best chemotherapy and radiotherapy combination regimen, but specific randomized trials addressing this issue are still lacking. Areas covered: A systematic review of the literature was performed searching in PubMed all published studies of combinations CTRT regimens for operable or unresectable esophageal cancer to describe activity and toxicity. Studies considered were prospective series or clinical phase II-III trials including at least 40 patients and published in English language. Expert commentary: Long-term results of CROSS trial have established RT combined with carboplatin plus paclitaxel chemotherapy as the preferred neoadjuvant treatment option for both squamous and adenocarcinoma of the esophagus. More effective multimodal treatment strategies integrating novel biological agents including immunotherapy and based on an extensive molecular tumor characterization are eagerly awaited.

Keywords: Chemoradiotherapy; chemotherapy; esophageal cancer; neoadjuvant; regimens.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / therapy
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy
  • Chemoradiotherapy / adverse effects
  • Chemoradiotherapy / methods*
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / therapy*
  • Esophagogastric Junction / pathology
  • Humans
  • Neoadjuvant Therapy / adverse effects
  • Neoadjuvant Therapy / methods