Table 2.

Randomized trials of preoperative radiotherapy (RT) and surgery versus surgery alone.

Study, year [Reference]	Participants	Number of patients	Interventions	Median Survival (Months)	Survival Rate (%)					Adverse Effects (Number of Patients)
					1 yr	2 yr	3 yr	4 yr	5 yr
Launois et al. 1981 [21]	124 patients March 1973-June 1976 France, single centre, squamous cell	67	64 – 90 Gy preop RT + esophagectomy	4.5	46	20	15	14	10	perioperative mortality was 23% in both groups.
		versus	versus	versus	versus
		57	esophagectomy (left thoracotomy)	8.2 (mean)	50	35	25	20	12
					p = NS, but NR
Gignoux et al. 1987 [22]	229 patients [dates not reported] EORTC, 8 centres, squamous cell, no cervical lesions, no previous cancer, no previous treatment.	115	33 Gy preop RT + esophagectomy	12.3	55	24	20	17	10	tracheosophageal fistula, 2; bleeding, 1; esophagitis, 1; respiratory deaths, 6
		versus	versus	versus	versus					versus
		114	esophagectomy	12 (mean)	57	30	14	11	9	respiratory deaths, 8
					No difference in survival (p = 0.94), but RT may delay local recurrence
Wang et al. 1989 [23]	206 patients June 1977-May 1985 China, single centre histology not reported < 65 years age, < 8 cm length no metastases	104	40 Gy preop RT + esophagectomy	NR	-	-	-	-	35	leaks, 1; perioperative deaths, 5
		versus	versus	versus	versus					versus
		102	esophagectomy	NR	-	-	-	-	30	leaks, 5; perioperative deaths, 5
					No difference in survival (p > 0.05).
Nygaard* 1992 [24]	108 patients Jan 1983-Jan 1988 Scandinavia, multi centre squamous cell < 75 years of age, Karnofsky score > 50, T1, T2, Nx, M0 > 21 cm from incisors	58	35 Gy preop RT + esophagectomy	10	44	25	21	-	-	respiratory, 5; leaks, 2; postoperative deaths, 4
		versus	versus	versus	versus					versus
		50	esophagectomy	7	34	13	9	-	-	respiratory, 5; leaks, 2; postoperative deaths, 5
					No difference in survival (p = 0.08).
Arnott 1992 [25]	176 patients 1979–1983 Scotland, single centre < 80 years, squamous cell adenocarcinoma, distal 2/3 esophagus	90	20 Gy preop RT + esophagectomy	8	40	22	13	9	9	respiratory, 10; postoperative deaths, 10
		versus	versus	versus	versus					versus
		86	esophagectomy (left thoracoabdominal)	8	40	28	23	21	17	respiratory, 5; postoperative deaths, 8; surgical, 2
					No difference in survival (p = 0.40).
Fok* 1994 [5]	79 patients 1968–1981 Hong Kong, single centre Squamous cell, middle 1/3 esophagus	40	24–53 Gy preop RT + esophagectomy	11	42	34	24	10	10	respiratory, 20; postoperative deaths, 12; leaks 11
		versus	versus	versus	versus					versus
		39	esophagectomy (right thoracotomy, left neck, and abdomen)	22	58	36	24	16	16	respiratory, 15; postoperative deaths, 3; leaks, 7
					No difference in survival.

*Patients randomized to four groups; data shown are for radiotherapy + surgery versus surgery alone.

Note: EORTC, European Organization for Research and Treatment of Cancer.