nach oben

Erschienen in:

01.07.2014 | Original Article

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

verfasst von: Natsuya Katada, Keishi Yamashita, Chikatoshi Katada, Hiromitsu Moriya, Kei Hosoda, Hiroaki Mieno, Katsuhiko Higuchi, Shoko Komori, Hiromichi Ishiyama, Kazushige Hayakawa, Mitsuhiro Sugawara, Satoshi Tanabe, Wasaburo Koizumi, Shiro Kikuchi, Masahiko Watanabe

Erschienen in: Esophagus | Ausgabe 3/2014

Einloggen, um Zugang zu erhalten

Abstract

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 70–75 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.

Burmeister BH, Smithers BM, Gebski V, Fitzgerald L, Simes RJ, Ackland S, Devitt P, Gotley DC, Joseph D, Millar J, North J, Walpole ET, Denham JW. Australasian Gastro-Intestinal Trials Group. Surgery alone versus chemoradiotherapy followed by surgery for resectable cancer of the oesophagus: a randomised controlled phase III trial. Lancet Oncol. 2005;6:659–68.PubMedCrossRef

Tepper J, Krasna MJ, Niedzwiecki D, Hollis D, Reed CE, Goldberg R, Kiel K, Willett C, Sugarbaker D, Mayer R. Phase III trial of trimodality therapy with cisplatin, fluorouracil, radiotherapy, and surgery compared with surgery alone for esophageal cancer: CALGB 9781. J Clin Oncol. 2008;26:1086–92.PubMedCrossRef

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;19:305–13.PubMed

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;21:4592–6.PubMedCrossRef

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;19:68–74.PubMedCrossRef

Ferri LE, Ades S, Alcindor T, Chasen M, Marcus V, Hickeson M, Artho G, Thirlwell MP. Perioperative docetaxel, cisplatin, and 5-fluorouracil (DCF) for locally advanced esophageal and gastric adenocarcinoma: a multicenter phase II trial. Ann Oncol. 2012;23:1512–7.PubMedCrossRef

Shah MA, Jhawer M, Ilson DH, Lefkowitz RA, Robinson E, Capanu M, Kelsen DP. Phase II study of modified docetaxel, cisplatin, and fluorouracil with bevacizumab in patients with metastatic gastroesophageal adenocarcinoma. J Clin Oncol. 2011;29:868–74.PubMedCentralPubMedCrossRef

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;66:1159–65.PubMedCentralPubMedCrossRef

Yokota T, Hatooka S, Ura T, Takahari D, Shitara K, Nomura M, Kondo C, Mizota A, Yatabe Y, Shinoda M, Muro K. Docetaxel plus 5-fluorouracil and cisplatin (DCF) induction chemotherapy for locally advanced borderline-resectable T4 esophageal cancer. Anticancer Res. 2011;31:3535–41.PubMed

10.

Yamasaki M, Miyata H, Tanaka K, Shiraishi O, Motoori M, Peng YF, Yasuda T, Yano M, Shiozaki H, Mori M, Doki Y. Multicenter phase I/II study of docetaxel, cisplatin and fluorouracil combination chemotherapy in patients with advanced or recurrent squamous cell carcinoma of the esophagus. Oncology. 2011;80:307–13.PubMedCrossRef

11.

Minsky BD, Pajak TF, Ginsberg RJ, Pisansky TM, Martenson J, Komaki R, Okawara G, Rosenthal SA, Kelsen DP. INT 0123 (Radiation Therapy Oncology Group 94-05) phase III trial of combined-modality therapy for esophageal cancer: high-dose versus standard-dose radiation therapy. J Clin Oncol. 2002;20:1167–74.PubMedCrossRef

12.

Hara H, Daiko H, Kato K, Igaki H, Kadowaki S, Tanaka Y, Hamamoto Y, Matsushita H, Nagase M, Hosoya Y, Tahara M. Final results of feasibility study of neoadjuvant chemotherapy with docetaxel, cisplatin, and fluorouracil (DCF) for clinical stage II/III esophageal squamous cell carcinoma. 2011 ASCO Annual Meeting 2011; General Poster Session: Abstract number 4060.

13.

Japanese Society for Esophageal Disease. Guidelines for the clinical and pathological studies on carcinoma of the esophagus. 10th ed. Kanehara (Tokyo); 2002.

14.

Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibanes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M. The Clavien–Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250:187–96.PubMedCrossRef

Titel: Neoadjuvant chemotherapy using concurrent Docetaxel/CDDP/5-FU (DCF) in esophageal squamous cell carcinoma and its short-term prognosis
verfasst von: Natsuya Katada
Keishi Yamashita
Chikatoshi Katada
Hiromitsu Moriya
Kei Hosoda
Hiroaki Mieno
Katsuhiko Higuchi
Shoko Komori
Hiromichi Ishiyama
Kazushige Hayakawa
Mitsuhiro Sugawara
Satoshi Tanabe
Wasaburo Koizumi
Shiro Kikuchi
Masahiko Watanabe
Publikationsdatum: 01.07.2014
Verlag: Springer Japan
Erschienen in: Esophagus / Ausgabe 3/2014
Print ISSN: 1612-9059
Elektronische ISSN: 1612-9067
DOI: https://doi.org/10.1007/s10388-014-0422-z

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

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