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Esophageal Squamous Cell Carcinoma pp 177–195Cite as

Neoadjuvant and Adjuvant Therapy

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Abstract

Most clinicians today are conscious of the necessity of a multimodality approach to improve the outcome of esophageal cancer victims. What results of clinical trials are available in Western countries are not applicable to clinical practice related to esophageal cancer in Asia, because of considerable East–West differences in this field. In Japan, the emphasis in surgical adjuvant therapy for patients with squamous cell carcinoma shifted from postoperative radiotherapy in the 1980s to postoperative chemotherapy, including cisplatin as a key drug in the 1990s. Later, the optimal timing for perioperative adjuvant therapy returned to preoperative treatment in the late 2000s, based on the results of a JCOG study (JCOG9907) comparing preoperative chemotherapy using cisplatin and 5-fluorouracil (CF) with postoperative chemotherapy. The most recent meta-analysis consisting of 12 randomized controlled trials comparing preoperative chemoradiotherapy vs. surgery alone showed a significant survival benefit of preoperative chemoradiotherapy in both histologic types, squamous cell carcinoma and adenocarcinoma. Next, the clinical question of which is better, preoperative aggressive chemotherapy or preoperative chemoradiotherapy, still requires resolution. The JEOG has launched a three-arm randomized controlled trial to confirm the superiority of DCF (CF plus docetaxel) and the superiority of chemoradiotherapy in overall survival over CF as preoperative therapy for locally advanced esophageal squamous cell carcinoma. Clinical trials incorporating molecular-targeted therapeutics into multimodality treatment for esophageal cancer will be initiated in the near future.

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  1. Department of Surgery, International Goodwill Hospital, 1-28-1, Nishigaoka, Izumiku, Yokohama, 245-0006, Japan

    Nobutoshi Ando MD

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Correspondence to Nobutoshi Ando MD .

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  1. Department of Surgery, International Goodwill Hospital, Yokohama, Kanagawa, Japan

    Nobutoshi Ando

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Ando, N. (2015). Neoadjuvant and Adjuvant Therapy. In: Ando, N. (eds) Esophageal Squamous Cell Carcinoma. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54977-2_11

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  • DOI: https://doi.org/10.1007/978-4-431-54977-2_11

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  • Online ISBN: 978-4-431-54977-2

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