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Between January 1970 and December 1983, 148 patients of esophageal carcinoma were treated surgically in the 2nd Department of Surgery, Osaka University Medical School. Among these patients, 70 (48.6%) with suspected invasion to neighboring structures were treated with preoperative chemotherapy, radiotherapy or a combination of both. The chemotherapeutic agents used were tegafur (FT-207)-suppository, bleomycin (BLM) or peplomycin (PEP). Radiotherapy (3000-4000 cGy) for selected cases was begun at the same time as the chemotherapy. Three to four weeks after the chemotherapy and radiotherapy were completed, esophagectomy was performed. The effects of the preoperative adjuvant therapies were investigated in these patients, and the following results were obtained: A marked histological effect, according to the Guide Lines in Clinical and Pathologic Studies for Carcinoma of the Esophagus (Japanese Society for Esophageal Diseases, 1976) was found in 47.4% of the radiotherapy plus FT-207 group, 39.1% of the group receiving radiotherapy alone and 28.6% of the group receiving radiotherapy plus PEP or BLM. Radiotherapy plus FT-207 showed excellent effects (77.8% of this group showed marked histological effects) on well differentiated squamous cell carcinoma, as shown histologically by biopsy specimens. Tumors exhibiting sharp edged margins radiographically and endoscopically, showed a very good histological effect after preoperative radiotherapy. Metastatic lymph nodes present in the irradiation field, whose primary lesion showed a marked histological effect, also gave excellent results. Postoperative radiotherapy is also expected to be equally effective on these cases.
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