Chemotherapy and Chemoradiotherapy Studies in Oesophageal Cancer

The aim of this thesis was, first, to explore the use of preoperative chemoradiotherapy and palliative chemotherapy in the treatment of oesophageal cancer. Furthermore, the effects of a chemoradiotherapy regimen on histopathological and psychological and social level were studied. Chapter 2 provides a review of the literature on systemic treatment for oesophageal cancer. An overview is given for preoperative and postoperative chemotherapy, preoperative chemoradiotherapy, definitive chemoradiotherapy, and palliative chemotherapy. In Chapter 3 the efficacy and safety of preoperative chemoradiotherapy consisting of carboplatin and paclitaxel and concurrent radiotherapy for patients with resectable oesophageal cancer is studied. Chapter 4 describes the histopathological effects of the above mentioned chemoradiotherapy regimen and correlates the effect of specific pathologic and clinical findings to overall survival. In Chapter 5 the health related quality of life up to one year after surgery, in patients with oesophageal cancer treated with curative intent with neoadjuvant chemoradiotherapy consisting of the above mentioned regimen followed by oesophagectomy is evaluated. Finally, in Chapter 6 the analysis of a phase II study evaluating the safety and efficacy of the combination of oxaliplatin and capecitabine in patients with metastatic or local-regional unresectable carcinoma of the oesophagus, oesophagogastric junction, and cardia is given. In addition, the effect of this regimen of the patients’ well-being is evaluated by performing a quality of life analysis on these patients during the treatment. The studies described in this thesis are summarized in Chapter 7. Furthermore, potential directions for future studies are addressed.

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