This approach is becoming standard therapy, he said, "but this study gives the proof positive that that's the way it should go."
Flores said although the treatment adds initial cost, it can save money. "If it leads to more cures, it's going to save money," he said.
Patients need to make sure this approach is discussed with them "so they just don't run straight to surgery," Flores said.
Dr. Harvey Mamon is clinical director of the department of radiation oncology at Brigham and Women's Hospital and Dana Farber Cancer Institute in Boston. He said: "This is an important and well-done study that will influence practice patterns. For all intents and purposes, the standard of care for locally advanced esophageal cancer was already preoperative chemo-radiation followed by surgery."
The significant improvement in the chemo-radiation portion in this trial confirms this current standard of care, he said. "I don't think we're likely to see further trials of surgery alone versus surgery following chemo-radiation."
For more information on esophageal cancer, visit the U.S. National Cancer Institute.
SOURCES: Ate van der Gaast, M.D., Ph.D., medical oncology, Erasmus University Hospital, the Netherlands; Raja Flores, M.D., chief of thoracic surgery, Mount Sinai Hospital, New York City; Harvey Mamon M.D., Ph.D., clinical director, department of radiation oncology, Brigham and Women's Hospital and Dana Farber Cancer Institute, associate professor, radiation oncology, Harvard Medical School, Boston; May 31, 2012, New England Journal of Medicine
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