Chemotherapy, radiation therapy, and surgery are all used to treat esophageal cancer, but doctors are trying to determine the most effective way to give them. Not all patients respond the same way to therapy. In this study, investigators are using positron emission tomography (PET) scanning, combined with computed tomography (CT) scanning, to monitor how patients with stage II or III esophageal cancer respond to chemotherapy and to determine the most appropriate therapy they should continue having based on the scan results.
Patients will be randomly assigned to start treatment with one of two chemotherapy regimens: a combination of drugs collectively called FOLFOX6, or two drugs called carboplatin and paclitaxel. Patients will then receive radiation therapy followed by surgery.
After completion of two to three cycles of chemotherapy (depending on which regimen they start on), patients will have a PET/CT scan. If the scan results suggest a good response to treatment, they will continue receiving the same chemotherapy. If the tumor response is not sufficient, doctors will switch patients to the other treatment (FOLXFOX6 to carboplatin/paclitaxel, or vice versa) during the radiation therapy period. Investigators will determine if using PET/CT scanning to guide treatment can improve patient outcomes.