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

Masashi Hashimoto, Yasuhiro Shirakawa, Naoaki Maeda, Shunsuke Tanabe, Kazuhiro Noma, Kazufumi Sakurama, Kuniaki Katsui, Masahiko Nishizaki, Toshiyoshi Fujiwara

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Abstract

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.

Original languageEnglish
JournalEsophagus
DOIs
Publication statusAccepted/In press - Jan 1 2020

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docetaxel
Chemoradiotherapy
Esophageal Neoplasms
Fluorouracil
Cisplatin
Survival
Recurrent Laryngeal Nerve
Vocal Cord Paralysis
Febrile Neutropenia
Anastomotic Leak
Esophagectomy
Diarrhea
Fasting
Therapeutics
Safety

Keywords

  • Chemoradiotherapy
  • DCF-RT
  • Esophageal cancer
  • Neoadjuvant chemoradiotherapy
  • T4b

ASJC Scopus subject areas

  • Gastroenterology

Cite this

@article{567d4009f3874a50b7b2c63ab99fd935,
title = "Induction chemoradiotherapy including docetaxel, cisplatin, and 5-fluorouracil for locally advanced esophageal cancer",
abstract = "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.",
keywords = "Chemoradiotherapy, DCF-RT, Esophageal cancer, Neoadjuvant chemoradiotherapy, T4b",
author = "Masashi Hashimoto and Yasuhiro Shirakawa and Naoaki Maeda and Shunsuke Tanabe and Kazuhiro Noma and Kazufumi Sakurama and Kuniaki Katsui and Masahiko Nishizaki and Toshiyoshi Fujiwara",
year = "2020",
month = "1",
day = "1",
doi = "10.1007/s10388-019-00709-5",
language = "English",
journal = "Esophagus",
issn = "1612-9059",
publisher = "Springer Japan",

}

TY - JOUR

T1 - Induction chemoradiotherapy including docetaxel, cisplatin, and 5-fluorouracil for locally advanced esophageal cancer

AU - Hashimoto, Masashi

AU - Shirakawa, Yasuhiro

AU - Maeda, Naoaki

AU - Tanabe, Shunsuke

AU - Noma, Kazuhiro

AU - Sakurama, Kazufumi

AU - Katsui, Kuniaki

AU - Nishizaki, Masahiko

AU - Fujiwara, Toshiyoshi

PY - 2020/1/1

Y1 - 2020/1/1

N2 - 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.

AB - 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.

KW - Chemoradiotherapy

KW - DCF-RT

KW - Esophageal cancer

KW - Neoadjuvant chemoradiotherapy

KW - T4b

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U2 - 10.1007/s10388-019-00709-5

DO - 10.1007/s10388-019-00709-5

M3 - Article

C2 - 31897761

AN - SCOPUS:85077635211

JO - Esophagus

JF - Esophagus

SN - 1612-9059

ER -