Concurrent Chemoradiotherapy with Protracted Infusion of 5-FU and Cisplatin for Postoperative Recurrent or Residual Esophageal Cancer

• Published in: Japanese journal of clinical oncology Vol. 33; no. 7; pp. 341 - 345
• Main Authors: Nishimura, Yasumasa, Koike, Ryuta, Nakamatsu, Kiyoshi, Kanamori, Shuichi, Suzuki, Minoru, Shigeoka, Hironori, Shiozaki, Hitoshi
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.07.2003; Oxford Publishing Limited (England)
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cisplatin - administration & dosage; Combined Modality Therapy; Dose Fractionation, Radiation; Drug Administration Schedule; Esophageal Neoplasms - drug therapy; Esophageal Neoplasms - radiotherapy; Esophageal Neoplasms - surgery; Feasibility Studies; Female; Fluorouracil - administration & dosage; Humans; Key words: esophageal cancer – loco-regional recurrence – radiotherapy – chemotherapy – surgery; Male; Middle Aged; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - radiotherapy; Neoplasm, Residual; Postoperative Period
• ISSN: 0368-2811; 1465-3621; 1465-3621
• DOI: 10.1093/jjco/hyg065

Background: We carried out the present study to investigate the feasibility and effectiveness of concurrent chemoradiotherapy (CT-RT) for postoperative recurrent esophageal cancer, which are, at present, unclear. Methods: Between 1998 and 2002, 16 patients with postoperative loco-regional recurrence of esophageal cancer, and two patients with incompletely resected esophageal cancer were treated with concurrent CT-RT. Patients received protracted infusion of 5-FU 250–300 mg/m2 on days 1 to 14, 1 hour infusion of cisplatin 10 mg/body on days 1 to 5 and 8 to 12, and a concurrent radiotherapy (RT) dose of 30 Gy in 15 fractions over 3 weeks. This treatment schedule was repeated twice with a gap of 1 week, for a total RT dose of 60 Gy administered over 7 weeks. Results: Of the 18 patients, 13 (72%) completed the CT-RT protocol. A total RT dose of 60 Gy was administered for all except two patients, and doses of chemotherapy were reduced for five patients. Although grade 3 hematological toxicities were frequently noted, non-hematological toxicities of grades 3 and 4 were few. Of the 18 tumors, five (28%) showed complete response (CR). For patients without prior chemotherapy, the CR rate was 40% (4/10). The 2-year survival rate of 13 patients without distant metastases was 19%, with a median survival time of 9.5 months. Conclusion: The concurrent CT-RT protocol appears feasible and effective for patients with postoperative recurrent or residual esophageal cancer.