Pre-operative Chemotherapy and Radiation Therapy for Esophageal Carcinoma

Patient Eligibility: Histologically confirmed squamous cell carcinoma, adenocarcinoma, or mixed adeno/squamous of the the esophagus or gastroesophageal junction. Disease limited to the esophagus and regional lymph nodes. However, celiac node enlargement will be acceptable for tumors of the distal esophagus, because they will be included in the radiation field. Disease must be able to be encompassed in a single radiation field. No medical contraindication to surgery. All treatment is to be administered at the University of Michigan Medical Center Karnofsky Performance Status > 60% Ages 18-75 Adequate renal function (BUN <1.5 x N; creatinine <1,5 mg/dl, or measured creatinine clearance>60 ml/min.). Adequate bone marrow reserve (WBC>3500/ul; Platelets>100,000/ul.). Adequate hepatic function (Bilirubin<1.5x N; AST <2 x upper limit of normal). Prior malignancy is acceptable if the patient is considered to be cured. In most cases this will mean a 5 year disease-free period. Ability to give informed consent. Exclusion Criteria: Patients with active infection, pregnancy, lactating females, serious inter-current medical conditions including congestive heart failure, cardiac arrhythmias, or symptomatic coronary artery diseases are ineligible. No prior treatment allowed. No prior thoracic radiation.