Outcomes of treatment of unresectable esophageal carcinoma treated with chemoradiotherapy and oral metronomic chemotherapy: An experience from a rural cancer center

Abstract

Introduction: Esophageal carcinoma is the eight most common cancer in the world. The management of locally advanced
carcinoma esophagus is mainly palliative with chemoradiotherapy. The outcome data of such a modality along with oral
metronomic chemotherapy after treatment completion are sparse. Here, we present the outcomes of treatment of locally advanced
unresectable esophageal cancer after palliative chemoradiotherapy and oral metronomic therapy from a rural setting in India.
Methods: Retrospective analysis of all patients of locally advanced unresectable nonmetastatic esophageal carcinoma treated
with short course of induction chemotherapy followed by radiotherapy/chemoradiotherapy and oral metronomic chemotherapy
was performed. The primary aim was estimation of progression free-survival (PFS) and overall survival (OS). Results: A total of
45 patients were analyzed. Mean age was 55 years (30-85 years). A total of 32 patients had tumors in upper and middle esophagus,
with the most common histology being squamous cell carcinoma (N-41). The estimated 2 year PFS is 47.2% and the estimated
2 years OS is 57.8%. Conclusion: Combined modality therapy with adjuvant oral metronomic therapy shows promising results in
the management and should be the basis of further trials.