Neoadjuvant chemotherapy using concurrent Docetaxel/CDDP/5-FU (DCF) in esophageal squamous cell carcinoma and its short-term prognosis

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• 作者：Natsuya Katada (1)
  Keishi Yamashita (1)
  Chikatoshi Katada (2)
  Hiromitsu Moriya (1)
  Kei Hosoda (1)
  Hiroaki Mieno (1)
  Katsuhiko Higuchi (2)
  Shoko Komori (3)
  Hiromichi Ishiyama (3)
  Kazushige Hayakawa (3)
  Mitsuhiro Sugawara (4)
  Satoshi Tanabe (2)
  Wasaburo Koizumi (2)
  Shiro Kikuchi (1)
  Masahiko Watanabe (1)
  
• 关键词：Esophageal squamous cell carcinoma ; Neoadjuvant chemotherapy ; Clinical outcome ; Multivariate analysis
• 刊名：Esophagus
• 出版年：2014
• 出版时间：July 2014
• 年：2014
• 卷：11
• 期：3
• 页码：173-181
• 全文大小：532 KB
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  3. Urba SG, Orringer MB, Turrisi A, Iannettoni M, Forastiere A, Strawderman M. Randomized trial of preoperative chemoradiation versus surgery alone in patients with locoregional esophageal carcinoma. J Clin Oncol. 2001;19:305-3.
  4. Ando N, Iizuka T, Ide H, Ishida K, Shinoda M, Nishimaki T, Takiyama W, Watanabe H, Isono K, Aoyama N, Makuuchi H, Tanaka O, Yamana H, Ikeuchi S, Kabuto T, Nagai K, Ikeuchi S, Kabuto T, Nagai K. Surgery plus chemotherapy compared with surgery alone for localized squamous cell carcinoma of the thoracic esophagus: a Japan Clinical Oncology Group Study-JCOG9204. J Clin Oncol. 2003;21:4592-. CrossRef
  5. Ando N, Kato H, Igaki H, Shinoda M, Ozawa S, Shimizu H, Nakamura T, Yabusaki H, Aoyama N, Kurita A, Ikeda K, Kanda T, Tsujinaka T, Nakamura K, Fukuda H. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol. 2012;19:68-4. CrossRef
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  8. Tanaka Y, Yoshida K, Sanada Y, Osada S, Yamaguchi K, Takahashi T. Biweekly docetaxel, cisplatin, and 5-fluorouracil (DCF) chemotherapy for advanced esophageal squamous cell carcinoma: a phase I dose-escalation study. Cancer Chemother Pharmacol. 2010;66:1159-5. CrossRef
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• 作者单位：Natsuya Katada (1)
  Keishi Yamashita (1)
  Chikatoshi Katada (2)
  Hiromitsu Moriya (1)
  Kei Hosoda (1)
  Hiroaki Mieno (1)
  Katsuhiko Higuchi (2)
  Shoko Komori (3)
  Hiromichi Ishiyama (3)
  Kazushige Hayakawa (3)
  Mitsuhiro Sugawara (4)
  Satoshi Tanabe (2)
  Wasaburo Koizumi (2)
  Shiro Kikuchi (1)
  Masahiko Watanabe (1)
  
  1. Department of Surgery, Kitasato University School of Medicine, 2-1-1 Asamizodai, Minami-ku, Sagamihara, Kanagawa, 252-0380, Japan
  2. Department of Gastrointestinal Oncology, Kitasato University School of Medicine, Sagamihara, Japan
  3. Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, Sagamihara, Japan
  4. Department of Pharmacy, Kitasato University School of Medicine, Sagamihara, Japan
  
• ISSN：1612-9067

文摘

Background Our aim in this study is to know whether clinical outcomes are improved by neoadjuvant chemotherapy (NAC) using Docetaxel/CDDP/5-FU (DCF) as compared to NAC using 5-FU/CDDP (FP). Methods Thirty-eight patients who underwent DCF NAC in cStage II/III esophageal squamous cell carcinoma (ESCC) were compared with the 41 counterparts treated by FP NAC. Docetaxel and CDDP were both given to 70-5?mg/m2 with concurrent 5-FU at 750?mg/m2 in 3 cycles. Median follow-up term of DCF NAC reached 27?months. Results In DCF NAC, grade 3 adverse effects were recognized in 97?%, and completion rate of the DCF NAC was 86?%. In terms of PR?+?CR rate, DCF NAC was better (87?%) than FP NAC (59?%) (p?=?0.005). Five year progression-free survival (PFS) and overall survival (OS) of FP NAC were 32 and 69?%, respectively, and OS of FP NAC was excellent putatively due to adoption of definitive chemoradiation therapy for recurrent diseases. Furthermore, survival was in favor of DCF NAC as compared to FP NAC for OS (p?=?0.02) and PFS (p?=?0.10), while R0 resection rate was similar. The 1st multivariate prognostic analysis among all cases with NAC revealed that significant factors were resectability and NAC modality for OS and PFS. We then performed the 2nd stage multivariate prognostic analysis limited to R0 cases including pathologic factors, which again identified DCF NAC modality as an independent prognostic factor. Conclusion DCF NAC for ESCC demonstrated high response rates, and may improve patient survival with acceptable feasibility.