Between January 1970 and December 1983, 148 patients of esophageal
carcinoma were treated surgically in the 2nd Department of Surgery, Osaka University Medical School. Among these patients, 70 (48.6%) with suspected invasion to neighboring structures were treated with preoperative
chemotherapy,
radiotherapy or a combination of both. The chemotherapeutic agents used were
tegafur (FT-207)-suppository,
bleomycin (BLM) or
peplomycin (PEP).
Radiotherapy (3000-4000 cGy) for selected cases was begun at the same time as the
chemotherapy. Three to four weeks after the
chemotherapy and
radiotherapy were completed,
esophagectomy was performed. The effects of the preoperative adjuvant
therapies were investigated in these patients, and the following results were obtained: A marked histological effect, according to the Guide Lines in Clinical and Pathologic Studies for
Carcinoma of the Esophagus (Japanese Society for
Esophageal Diseases, 1976) was found in 47.4% of the
radiotherapy plus
FT-207 group, 39.1% of the group receiving
radiotherapy alone and 28.6% of the group receiving
radiotherapy plus PEP or BLM.
Radiotherapy plus
FT-207 showed excellent effects (77.8% of this group showed marked histological effects) on well differentiated
squamous cell carcinoma, as shown histologically by biopsy specimens.
Tumors exhibiting sharp edged margins radiographically and endoscopically, showed a very good histological effect after preoperative
radiotherapy. Metastatic lymph nodes present in the irradiation field, whose primary lesion showed a marked histological effect, also gave excellent results. Postoperative
radiotherapy is also expected to be equally effective on these cases.