Postoperative cancer therapy for patients with carcinoma of the thoracic esophagus: an attempt of aggressive chemotherapy combined with proper nutritional support for patients with distant node metastasis.

The prognosis of patients with advanced thoracic esophageal carcinoma is still poor. In general, patients having distant lymph-node metastasis do not survive for more than 3 years. Therefore, a new therapeutic regimen employing aggressive chemotherapy for these patients has been attempted. In this regimen, three kinds of anticancer drugs Pepleomycin, and twice as much as Adriamycin and Mitomycin of the conventional level for a short period of time are used. Eleven cases were treated with this chemotherapy under active enteral and parenteral nutritional support of 45 to 50 kcal/kg daily. Two patients over 70 years of age died of pneumonitis. Four patients with recurrence of cancer in the lungs, liver and cervical nodes died after 10, 12, 13 and 14 months following surgery, respectively. Five patients have been alive for more than 2 years. These results indicate that this therapy is more effective than other conventional therapies. It has been shown that aggressive chemotherapy combined with proper nutritional support is effective for patients with node metastasis.