DOI: 10.36347/sjmcr.2021.v09i08.010

Pages: 793-799

Background: Carcinoma of the esophagus is an aggressive disease. Neoadjuvant chemoradiotherapy achieves the highest complete pathologic response rates, R0 resection rates, and improves 3-5 years survival rates. Methods: Patients with resectable carcinoma oesophagus were included in this prospective study. 22 patients were enrolled. All eligible patients were given radiation for a total radiation dose of 41.4Gy in 23 fractions of 1.8Gy each with five fraction administered per week. Weekly chemotherapy given with carboplatin (AUC 2mg/mm/mt) and paclitaxel (50mg/m2 of BSA). The patients were monitored weekly during the treatment for toxicities. These patients were evaluated with CECT after four to six weeks, and sent for surgery. Histopathological reports of these patients which included lymph node status, pathological response and resection margins were noted. Results: A total of 22 patients were enrolled. Neutropenia was the most common hematological toxicity and 4.5% had grade 2 neutropenia.There was no Grade 3 or 4 hematological toxicity. Most common GI toxicity seen was esophagitis and anorexia. 1 patient developed grade 3 esophagitis. 22% patients had grade 2 anorexia.17 patients underwent surgery and all of them had negative resected margins, 5 out of these 17 patients had pathological complete response. Conclusion: Preoperative chemoradiotherapy with weekly paclitaxel and carboplatin have good clinical response in terms of negative resection margin and pathological complete response with accepted level of toxicity. Prospective trials in larger series of patients are needed with long follow up.