Preoperative Chemotherapy vs. Chemoradiation in Esophageal / GEJ Adenocarcinoma

Official Title

PreOperative Treatment With chEmotheRapy or chemoRAdiatioN in esophaGeal or gastroEsophageal adenocaRcinoma


The best treatment for resectable esophageal cancer or cancer between esophagus and stomach (GE junction) is unknown. Although an operation to remove the esophagus is the most common treatment, previous studies have shown that patients live longer when either chemotherapy or chemotherapy plus radiation (chemoradiation) is given before surgery (preoperative), compared to surgery alone. However it is unknown which of these treatments (preoperative chemotherapy or preoperative chemoradiation) is more effective in improving survival. A study where patients with resectable esophageal / GE junction cancer are chosen at random to receive one of the two preoperative treatments would help determine if one form of treatment improves survival compared to the other. Patients with localized esophageal / GE junction cancer (adenocarcinoma) will be randomized to receive either preoperative chemotherapy or preoperative chemoradiation followed by surgery. The main objective of this pilot trial is to determine the possibility of conducting a larger study with many centres participating. If this study proves to be feasible with enough patients enrolled and able to tolerate treatments without major side effects then we can hopefully proceed to perform a larger multi-centre trial to look for survival outcome differences between patients who receive preoperative chemotherapy and those who receive preoperative chemoradiation. The results of this trial would ultimately help us choose the most effective treatment of resectable esophageal cancer and hopefully improve survival.

Trial Description

Primary Outcome:

  • compliance with assigned neoadjuvant treatment
  • treatment response
Secondary Outcome:
  • survival
  • quality of life

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Canadian Cancer Society

These resources are provided in partnership with the Canadian Cancer Society