Would you consider induction chemotherapy prior to starting chemoradiation therapy in squamous cell carcinoma of the esophagus?

Topics: Radiation Oncology • Gastrointestinal Cancers • Esophageal Cancer • Medical Oncology

If the patient has large, bulky nodes would you consider starting after chemotherapy for cytoreduction? Or otherwise consider replanning mid-treatment if there is significant change in tumor volumes?

Answer from: Radiation Oncologist at Academic Institution

Time and again, studies have shown that induction therapy for squamous cell carcinoma, seemingly regardless of primary tumor origin, probably does not improve the outcomes for patients compared to upfront chemoradiation therapy. For example in Head & Neck squamous cell cancers, the use of induc...

Comments

Radiation Oncologist at Brigham and Women's Hospital
I agree, and would also point out two relevant ran...

Answer from: Radiation Oncologist at Academic Institution

I agree with the answer posted above. For the sake of fairness, the referenced Stahl trial did use induction chemotherapy (a very complicated regimen), but the FFCD did not. Both studies established that definitive chemoradiation has equivalent overall survival to chemoradiation followed by surgery ...

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