A Phase II Study of Neoadjuvant Chemoradiotherapy with Docetaxel, Cisplatin and 5-FU Followed by Surgical Resection in the Treatment of Locally Advanced Esophagogastric Junction Cancer and Locally Advanced Esophageal Cancer

• Published in: Clinics and practice 2024-04, Vol.14 (2), p.642-652
• Main Authors: Chen, Chien-Chih, Yeh, Hui-Ling, Chuang, Cheng-Yeh, Hsu, Chung-Ping
• Format: Article
• Language: English
• Subjects: Angina pectoris; Cancer therapies; chemoradiotherapy; Chemotherapy; Clinical outcomes; Disease; Drug dosages; Endoscopy; Esophageal cancer; gastrointestinal cancer; Heart failure; Hepatitis; Investigations; Metastasis; neoadjuvant therapy; Radiation therapy; Skin cancer; Squamous cell carcinoma; Surgery; Toxicity; Tumors
• ISSN: 2039-7283; 2039-7275; 2039-7283
• DOI: 10.3390/clinpract14020051

Purpose: We conducted a phase II study evaluating chemoradiotherapy in patients with advanced esophageal cancer, using the docetaxel, cisplatin, and 5-fluorouracil (DCF) regimen followed by surgery. The primary purposes of this clinical trial were to assess the efficacy and safety of chemoradiotherapy employing the DCF regimen in the treatment of advanced esophageal cancer. Material and methods: We enrolled a total of 24 newly diagnosed esophageal cancer patients between April 2015 and November 2017 in this prospective study. The radiotherapy regimen consisted of a total dose of 45 Gy in 25 fractions. The chemotherapy protocol included docetaxel 35 mg/m2 for 1 h on day 1 and day 29, cisplatin 35 mg/m2 for 1 h on day 1 and day 29, and 5-FU 400 mg/m2 for 24 h on day 1–4 and day 29–32. The patients who accepted the re-staging exam should undergo surgery in 4–8 weeks after the completion of radiotherapy. The primary endpoints of this study were disease-free survival (DFS), overall survival (OS), and the evaluation of hematologic toxicity. Results: The study population had a median age of 55.5 years, ranging from 44 to 66, with over 90% of the patients being male. The 5-year DFS was 37.1%, and the 5-year OS was 48.7%. The pathologic complete response rate was 45.8% (11/24). The most common types of toxicity were leukopenia and thrombocytopenia. No grade 3 or greater hematologic toxicity was reported. Conclusions: The use of the DCF regimen in neoadjuvant chemoradiotherapy followed by surgery demonstrated tolerable toxicity and achieved acceptable DFS and OS outcomes.