Radiotherapy,Chemotherapy,Before and After Surgery in Advanced Esophageal or Gastroesophageal Junction Cancer

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed squamous cell carcinoma, adenocarcinoma, or large cell undifferentiated cancer of the esophagus or gastroesophageal junction

  • T3, N1, or M1a disease only

  • The following types are not allowed:

    • Small cell undifferentiated carcinomas, lymphomas, or sarcomas
    • Small cell or mixed small cell/non-small cell histology
• No evidence of distant hematogenous tumor metastases (M1b)
• No malignant pleural effusions

PATIENT CHARACTERISTICS:

Performance status

• ECOG 0-1

Life expectancy

• Not specified

Hematopoietic

• WBC > 3,500/mm^3
• Platelet count > 100,000/mm^3

Hepatic

• Alkaline phosphatase < 2 times normal
• AST < 2 times normal
• No unstable or uncompensated hepatic disease

Renal

• Creatinine ≤ 2.0 mg/dL
• Calcium normal
• No unstable or uncompensated renal disease

Cardiovascular

• No unstable or uncontrolled angina
• No unstable or uncompensated cardiac disease

Pulmonary

• See Disease Characteristics
• No limitations to pulmonary function that would preclude study participation
• No evidence of clinically active interstitial lung disease (asymptomatic patients with chronic stable radiographic changes are allowed)
• No unstable or uncompensated respiratory disease

Other

• Not pregnant or nursing
• Fertile patients must use effective contraception
• No evidence of severe or uncontrolled systemic disease
• No other uncontrolled malignancy
• No active infection
• No known severe hypersensitivity to gefitinib or any of its excipients

PRIOR CONCURRENT THERAPY:

Biologic therapy

• No prior immunotherapy for this cancer

Chemotherapy

• No prior chemotherapy for this cancer

Radiotherapy

• No prior radiotherapy for this cancer

Surgery

• Recovered from any prior oncologic or other major surgery
• No prior surgical resection for this cancer
• No concurrent ophthalmic surgery

Other

• No prior photodynamic therapy for this cancer (prior laser treatments are acceptable)
• More than 30 days since prior unapproved or investigational drug
• No concurrent phenytoin, carbamazepine, barbiturates, rifampin, phenobarbital, or Hypericum perforatum (St. John's wort)