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75

NCCN Guidelines for Patients

®

Esophageal Cancer, Version 1.2016

6

Treatment guide: Adenocarcinoma

Invasive cancer

The regimen for preoperative chemotherapy is:

• 5-FU and cisplatin.

Regimens for perioperative chemotherapy are:

• 5-FU and cisplatin,

• Epirubicin, cisplatin, and 5-FU*,

• Epirubicin, oxaliplatin, and 5-FU*,

• Epirubicin, cisplatin, and capecitabine*, and

• Epirubicin, oxaliplatin, and capecitabine*.

*These perioperative regimens are not advised

by most NCCN experts.

Doctors call chemoradiation given to try to cure

cancer “definitive chemoradiation.” It is an option

if the tumor is rated T4b. Even if you are healthy

enough for surgery, these tumors can’t be first treated

with surgery.

Chemotherapy regimens for definitive chemoradiation

are:

Preferred regimens

• Cisplatin and 5-FU (or capecitabine)

• Oxaliplatin and 5-FU (or capecitabine)

• Paclitaxel and carboplatin

Other regimens

• Cisplatin with docetaxel or paclitaxel

• Irinotecan and cisplatin

• Paclitaxel and fluoropyrimidine (5-FU or

capecitabine).

Not approved or decline surgery

Guide 19 also lists options for people unable to have

surgery. Chemoradiation to try to cure the cancer is

an option if chemotherapy will do more good than

harm. Regimens for definitive chemotherapy are

listed in the left column.

If you are unable to have chemotherapy, supportive

care is advised. This may include radiation therapy

to prevent or treat symptoms caused by cancer.

Supportive care is addressed later in this chapter in

the section

Advanced cancer.