Survival following non-surgical multimodal treatment for oesophageal squamous cell carcinoma

Objective: A multimodal protocol was proposed for patients with oesophageal squamous cell carcinoma unfit for surgery who were referred for palliative endoscopic therapy. Our goal was to influence survival by a more aggressive approach than endoscopic procedures alone. Methods: The study included 286 patients (255 men, 31 women, mean age 65.3 years). According to the 1987 TNM classification, 24 patients (8.4%) had stage 1, 124 (43.4%) stage 2, 95 (33.2%) stage 3 and 43 (15%) stage 4 cancers. The therapeutic protocol consisted of a combination of local endoscopic procedures, regional treatment with radiotherapy and systemic treatment with chemotherapy. Results: Trimodal treatment was performed in 187 patients (65%). Bimodal treatment was applied in the other 99 patients because of contraindications to chemotherapy in 54 and to radiotherapy (metastatic cancer or tracheal involvement) in 45