Complete response in a case of advanced esophageal cancer infiltrating into the main bronchus treated by chemoradiation therapy

2013 
: We report a case of advanced esophageal cancer infiltrating into the trachea that was treated by chemoradiation therapy. The patient was a 49-year-old man who complained of dysphagia and dyspnea. Various examinations revealed an esophageal cancer with direct invasion into the trachea( cT4b[ Tr], N2[ 106recR, 106recL, 106pre, 1], M0, cStage IIIc). He underwent radiotherapy. Simultaneously, he was administered morphine to relieve dyspnea and steroid to prevent tracheal edema. From the eight day of radiation therapy, chemotherapy was initiated( DCF; docetaxe[l DTX] +cisplatin[ CDDP] + 5-fluorouracil[ 5-FU]). This chemoradiation therapy considerably reduced the esophageal tumor size. Thereafter, the patient underwent 2 additional courses of chemotherapy( FAP; 5-FU+adriamycin[ ADM] +CDDP). The therapeutic effect was judged as complete response. The patient is still alive without recurrence for 3 years and 6 months after the first treatment. There are some reports about airway stenting and adjuvant therapy for airway obstruction caused by esophageal cancer. However, there are few reports on chemoradiotherapy for esophageal cancer invading into the trachea with administration of steroids to prevent tracheal edema. We believe that this is an effective treatment.
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