Induction chemoradiotherapy including docetaxel, cisplatin, and 5-fluorouracil for locally advanced esophageal cancer

• Published in: Esophagus : official journal of the Japan Esophageal Society Vol. 17; no. 2; pp. 127 - 134
• Main Authors: Hashimoto, Masashi, Shirakawa, Yasuhiro, Maeda, Naoaki, Tanabe, Shunsuke, Noma, Kazuhiro, Sakurama, Kazufumi, Katsui, Kuniaki, Nishizaki, Masahiko, Fujiwara, Toshiyoshi
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.04.2020; Springer Nature B.V
• Subjects: Chemotherapy; Esophageal cancer; Esophagus; Gastroenterology; Medical prognosis; Medicine; Medicine & Public Health; Original Article; Radiation therapy; Surgical Oncology; Thoracic Surgery; Throat surgery; DCF-RT; T4b; Chemoradiotherapy; Esophageal cancer; Neoadjuvant chemoradiotherapy
• ISSN: 1612-9059; 1612-9067
• DOI: 10.1007/s10388-019-00709-5

Background Locally advanced esophageal cancer (EC) invading surrounding organs (T4b) is difficult to treat. In general, definitive chemoradiotherapy (d-CRT) has been chosen as treatment for such cases. However, the outcome has not been good. Recently, the effectiveness of d-CRT with docetaxel, cisplatin, and 5-fluorouracil (DCF-RT) has been reported. Furthermore, surgery after d-CRT has a better prognosis than d-CRT alone in some reports, although it has a high risk of surgical complications. This study investigated the effectiveness and safety of induction DCF-RT. Methods The subjects were EC patients who underwent induction DCF-RT in Okayama University Hospital between January 2011 and December 2017. Their background characteristics, treatment details, histopathological factors, adverse events during CRT, postoperative complications, and overall survival (OS) were assessed. Results A total of 16 cases were performed induction DCF-RT. In 10 cases, death occurred, with 9 cancer-related deaths, and 1 death due to other disease. For all cases, OS was 37.5% at 3 years. 12 cases underwent esophagectomy after DCF-RT. Their OS was 50% at 3 years. 13 patients (81.3%) had Grade 3 febrile neutropenia. In 7 cases (62.5%), fasting for the treatment of diarrhea was needed. Three patients (25%) developed anastomotic leakage. Some recurrent laryngeal nerve paralysis was observed in 6 cases (50%). Conclusion Although the rates of adverse events and surgical complications were slightly higher than in past reports, they were acceptable. It is useful to perform induction DCF-RT for T4b EC.