Gefitinib, Cisplatin, Irinotecan, and Radiation Therapy Before Surgery in Treating Patients With Esophageal Cancer or Gastroesophageal Junction Cancer That Can Be Removed By Surgery

DISEASE CHARACTERISTICS:

• Histologically confirmed adenocarcinoma (AC) or squamous cell carcinoma of the esophagus

  • AC of the gastroesophageal junction allowed

• Tumor must be considered surgically resectable (T1-3, NX)

  • No early-stage cancer (T1, N0)

• The following lymph node (LN) criteria are considered acceptable:

  • Regional thoracic LN metastases (N1)
  • LN metastases levels 15 to 20 measured as ≤ 1.5 cm by CT scan
  • Supraclavicular LN not palpable on clinical examination measured as ≤ 1.5 cm by CT scan
• No distant metastases (M0)

PATIENT CHARACTERISTICS:

• Platelet count ≥ 100,000/mm^3
• Absolute neutrophil count ≥ 1,500/mm^3
• Hemoglobin ≥ 9.0 g/dL
• Creatinine clearance ≥ 50 mL/min
• Creatinine serum level ≤ CTC grade 2
• Bilirubin ≤ 2 times upper limit of normal (ULN)
• AST < 3 times ULN
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during and for 3 months after completion of study treatment
• No known severe hypersensitivity to gefitinib or any of its excipients
• No evidence (except asymptomatic chronic stable radiographic changes) of clinically active interstitial lung disease
• No pulmonary fibrosis, Gilbert's disease, uncontrolled diabetes mellitus, or unstable angina
• No New York Heart Association class III or IV heart disease
• No other concurrent malignancies or malignancies diagnosed within the past 5 years except basal cell carcinoma or carcinoma in situ of the cervix
• No serious active or uncontrolled infection, systemic disease, psychiatric illness, or other medical condition that would preclude study participation
• No evidence of any significant clinical disorder or laboratory finding that would preclude study participation

PRIOR CONCURRENT THERAPY:

• No prior chemotherapy or radiotherapy for esophageal cancer
• No prior radiotherapy that would overlap the study treatment fields
• Recovered from prior major surgery
• No nonapproved or investigational drugs within the past 30 days
• No concurrent phenytoin, carbamazepine, barbiturates, rifampin, phenobarbital, or Hypericum perforatum (St. John's wort)