Preoperative radiation therapy for carcinoma of the esophagus.

From 1960 through 1973, 415 patients with carcinoma of the esophagus were treated with radiation therapy. Three hundred and thirty-two patients had planned preoperative irradiation to a dose of 4500 rads in 18 fractions, and 101 of these had subsequent resections with either colon or stomach replacement. The operative mortality in this group was 18% and the 2- and 5-year survivals were 22.8 and 13.6%, respectively. The dose of 4500 rads in 18 fractions produced tumor sterilization in 3% and reduction to in situ carcinoma in 10% of these 101 patients. The survival was considerably improved in this small group of patients. Those patients not amenable to exploration had a 3% 5-year and a 5.6% 2-year survival was 12.1%. The overall survival was 9% at 2 years and 6% at 5 years. The results in this series are compared with the most recent reports in the literature.