Long-term survival associated with metastatic small cell carcinoma of the esophagus treated by chemotherapy, autologous bone marrow transplantation, and adjuvant radiation therapy.

A 44-year-old woman had small cell carcinoma of the esophagus complicated by liver and lymph node metastases. She was treated with aggressive combination chemotherapy, followed by autologous bone marrow transplantation and adjuvant radiation therapy. (The authors believe this to be the first use of autologous bone marrow transplantation for treatment of this condition.) This regimen resulted in apparent complete regression of the disease as documented by computed tomography and endoscopic study. Three years later, she again experienced general malaise and was found to have extensive recurrent disease in the lung, bone, and liver. Her condition deteriorated rapidly, and she died within 1 month. A review of the literature reveals that this patient survived longer than any others who have had this rare but aggressive tumor. The authors suggest that this form of therapy should be considered for future patients.