Problems in neoadjuvant chemoradiotherapy preceding surgery for advanced squamous cell carcinoma of the thoracic esophagus
- 20 Downloads
The adverse effect of neoadjuvant chemoradiotherapy on the postoperative course in esophageal cancer was studied in 9 patients undergoing neoadjuvant chemoradiotherapy preceding surgery for thoracic esophageal carcinoma possibly involving adjacent organs (neoadjuvant group), and 13 patients undergoing surgery without neoadjuvant therapy for same disease (control group). The two groups were compared for volume of intraoperative hemorrhage, surgical duration, frequency of postoperative morbidity, and for postoperative changes in blood platelet counts, and serum thrombopoietin and interleukin-6 levels. Mean intraoperative blood loss was 1121 g (580–1,662 g) in the neoadjuvant group and 546.5 g (274.7–778.3 g) in controls group (Student’s T test: p < 0.01). No significant difference was seen found between the two groups in the degree of postoperative deterioration in cardiopulmonary function or in interleukin-6 levels. Blood platelet counts decreased in both groups until postoperative day 7, but recovery on postoperative day 14 was significantly depressed in the neoadjuvant group compared to controls. Serum thrombopoietin levels were higher in the neoadjuvant group than in controls (Mann-Whitney U-test: p < 0.05). We found that neoadjuvant chemoradiotherapy induces latent postoperative myelosuppression and may lead to intractable infection.
Index wordsesophageal cancer chemoradiotherapy neoadjuvant therapy
Unable to display preview. Download preview PDF.
- 3.Japanese society for esophageal diseases. Guidelines for clinical and pathologic studies on carcinoma of the esophagus. 6th ed. Tokyo: Kanehara, 1984: 24. (in Japanese).Google Scholar
- 4.Hermank P, Henson DE, Huttier RVP. TNM Supplement 1993. Berlin: Springer-Verlag, 1993: 119–20.Google Scholar
- 5.Siewert JR, Roder JD. Lymphadenectomy in esophageal cancer surgery. Dis Esophag. 1992; 5: 91.Google Scholar
- 7.Meng YG, Martin TG, Peterson ML, Shuman MA, Cohen RL, Wong WL. Circulating thrombopoietin concentration in thrombocytopenic patients, including cancer patients following chemotherapy, with or without peripheral blood progenitor cell transplantation. Br J Haematol 1996; 95: 535–41.PubMedCrossRefGoogle Scholar