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Adjuvant postoperative radiation therapy after curative resection of squamous cell carcinoma of the thoracic esophagus: A prospective randomized study

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Abstracts

Postoperative radiation therapy following curative resection of squamous cell carcinoma of the esophagus was investigated in a prospective randomized study. A group of 33 patients received postoperative radiation therapy and were compared to a control group of 35 patients treated by surgery alone. No statistically significant differences were noted between the two treatment groups concerning overall and disease-free survival rates. Postoperative irradiation significantly increased the incidence of fibrotic strictures of the esophagogastric or esophagocolonic anastomoses and caused a delayed recovery of patients quality of life. Based on these results, we believe that postoperative radiation therapy alone cannot be advocated as a adjuvant therapy following curative resection of squamous cell carcinoma of the esophagus.

Résumé

L'utilisation de la radiothérapie postopératoire après résection à visée curatrice des cancers épidermoídes de l'oesophage a été testée dans une étude randomisée. Trente trois patients recevant une radiothérapie postopératoire ont été comparés à 35 patients témoins traités par la chirurgie seule. Aucune différence significative n'a été retrouvée entre les deux groupes en ce qui concerne la survie globale ou la survie sans récidive. Par contre, la radiothérapie postopératoire augmente l'incidence de sténoses fibreuses au niveau des anastomoses oesogastriques ou oesocoliques de façon significative et retarde alors la récupération d'une certaine qualité de la vie. En raison de ces résultats, la radiothérapie scule ne pcut être indiquée comme thérapie adjuvante après la résection à titre curative de cancers épidermoíde de l'oesophage.

Resumen

La radioterapia postoperatoria luego de resección curativa del carcinoma escamocelular del esófago fue investigada en un estudio prospectivo y randomizado: 33 pacientes recibieron radioterapia postoperatoria y fueron comparados con un grupo control de 35 pacientes tratados mediante cirugía solamente. No se encontraron diferencias estadísticamente significativas en cuanto a las tasas de sobrevida global y de sobrevida libre de enfermedad. La radioterapia postoperatoria incrementó la incidencia de estrecheces fibróticas de las anastomosis esófago-gástrica o esófagocolónica en forma significativa y causó demora en la recuperación de la calidad de vida de los pacientes. En vista de estos resultados, no se puede preconizar la radioterapia postoperatoria de por sí como una modalidad terapéutica coadyuvante después de resección de un carcinoma escamocelular del esófago.

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Authors and Affiliations

  1. Department of Surgery Charité, Humboldt University of Berlin, Schumann-Strasse 20/21, D-10117, Berlin, Germany

    Hans U. Zieren M.D., Joachim M. Müller M.D. & Christoph A. Jacobi M.D.

  2. Department of Surgery, University of Cologne, Joseph-Stelzmann-Strasse 9, D-50924, Cologne, Germany

    Heinz Pichlmaier M.D.

  3. Department of Radiotherapy, University of Cologne, Joseph-Stelzmann-Strasse 9, D-50924, Cologne, Germany

    Rolf-Peter Müller M.D. & Sabine Staar M.D.

Authors
  1. Hans U. Zieren M.D.
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  2. Joachim M. Müller M.D.
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  3. Christoph A. Jacobi M.D.
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  4. Heinz Pichlmaier M.D.
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  5. Rolf-Peter Müller M.D.
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  6. Sabine Staar M.D.
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Zieren, H.U., Müller, J.M., Jacobi, C.A. et al. Adjuvant postoperative radiation therapy after curative resection of squamous cell carcinoma of the thoracic esophagus: A prospective randomized study. World J. Surg. 19, 444–449 (1995). https://doi.org/10.1007/BF00299187

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