scholarly journals Neoadjuvant Chemotherapy for Clinical Stage II and III Thoracic Esophageal Squamous Cell Carcinoma with Curative Esophagectomy

2015 ◽  
Vol 06 (15) ◽  
pp. 1207-1213 ◽  
Author(s):  
Masahide Ikeguchi ◽  
Yusuke Kohno ◽  
Kyoichi Kihara ◽  
Kazunori Suzuki ◽  
Kanenori Endo ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Clinical Stage ◽  
Stage Ii ◽  
Curative Esophagectomy

Feasibility study of neoadjuvant chemotherapy with docetaxel, cisplatin, and fluorouracil (DCF) for clinical stage II/III esophageal squamous cell carcinoma.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 95-95 ◽  
Author(s):  
K. Kato ◽  
H. Hara ◽  
H. Daiko ◽  
H. Igaki ◽  
Y. Hamamoto ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Feasibility Study ◽  
Squamous Cell ◽  
Clinical Stage ◽  
Completion Rate ◽  
Stage Ii ◽  
Serious Adverse Events

95 Background: In JCOG 9907, neoadjuvant chemotherapy with cisplatin and 5-fluorouracil (CF) improved overall survival without additional serious adverse events in treating stage II/III esophageal squamous cell carcinoma (ESCC). However, ESCC patient survival remains unsatisfactory. We conducted a feasibility study of neoadjuvant chemotherapy with docetaxel plus CF (DCF) for clinical stage II/III ESCC. Methods: Eligibility criteria included clinical stage II/III (non-T4) ESCC, PS 0–1, and age 20–70 years. Chemotherapy consisted of a 1-h infusion of docetaxel at 70 mg/m2 and 2-h infusion of cisplatin at 70 mg/m2 (day 1), and continuous infusion of 5-FU 750 mg/m2 (days 1 to 5). Antibiotic prophylaxis on days 5 to 15 was mandatory. This regimen was repeated every 3 weeks (maximum 3 cycles) until unacceptable toxicity, patient refusal, or disease progression was observed. After chemotherapy completion, transthoracic esophagectomy with extended (> D2) lymphadenectomy was performed. The primary endpoint was the completion rate of protocol treatment. Results: From July 2009 to Feb 2010, 34 patients were enrolled, including 2 ineligibles. The 32 eligibles had a median age of 61 (range 36–70; male/female: 30/2), with PS0/1 of 20/12 and cStage IIA/IIB/III of 6/8/18. During chemotherapy, the most common grade-3 or -4 toxicities were neutropenia (88%), febrile neutropenia (3%), anorexia (9%), and stomatitis (6%). Thirty-one (97%) patients underwent surgery. The protocol completion rate was 87.5% (28/32). No treatment-related death was observed, and the operative morbidity incidence was comparable to those in previous studies. According to RECIST, the overall response rate was 61.5% after DCF completion. Primary-lesion pathological complete response was achieved in 26% of patients (8/31) who underwent esophagectomy. Conclusions: Neoadjuvant DCF was well tolerated. Although these data are preliminary, the protocol is highly promising and warrants further investigation. No significant financial relationships to disclose.

Feasibility study of neoadjuvant chemoradiotherapy with cisplatin plus 5-fluorouracil and elective nodal irradiation for stage II/III esophageal squamous cell carcinoma.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 130-130 ◽  
Author(s):  
Takashi Kojima ◽  
Jun Hashimoto ◽  
Ken Kato ◽  
Yoshinori Ito ◽  
Hiroyasu Igaki ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Esophageal Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Feasibility Study ◽  
Squamous Cell ◽  
Neoadjuvant Chemoradiotherapy ◽  
Stage Ii ◽  
Elective Nodal Irradiation

130 Background: Based on the JCOG 9907 trial results, neoadjuvant chemotherapy with cisplatin (CDDP) plus 5-fluorouracil (5-FU) is considered a standard treatment for stage II/III esophageal squamous cell carcinoma (ESCC) in Japan. However, patient survival remains unsatisfactory. We conducted a feasibility study of neoadjuvant chemoradiotherapy (NeoCRT) with CDDP plus 5-FU and elective nodal irradiation for stage II/III ESCC. Methods: Eligibility criteria included clinical stage II/III (UICC 6th, non-T4) ESCC, PS 0-1, and age 20–75 years. Chemotherapy consisted of 2 courses of 5-FU infusion (1000 mg/m2, days 1–4) and a 2-h CDDP infusion (75 mg/m2, day 1), with a 4-week interval. Radiotherapy was concurrently administered to a total 41.4 Gy in 23 fractions for primary tumor, metastatic lymph nodes and regional lymph nodes. After completion of CRT, transthoracic esophagectomy with extensive lymphadenectomy (>D2) was performed. The primary endpoint was the completion rate of NeoCRT and R0 resection. Results: From July 2010 to June 2011, 33 patients were enrolled, including 2 ineligibles. In 31 eligible patients, the median age was 63 years (range, 40–73); male/female: 28/3; PS0/1: 19/12; cStage IIA/IIB/III: 2/10/19. During CRT, the most common grade 3 or 4 toxicities were leukopenia (65%), neutropenia (65%), anemia (13%), thrombocytopenia (13%), febrile neutropenia (13%), anorexia (16%), esophagitis (16%), and hyponatremia (16%). In total, 31 patients (100%) underwent CRT and 25 (81%) underwent surgery; 1 patient (3%) did not undergo surgery due to disease progression, and the other 5 patients (16%) are scheduled for surgery. Among patients who underwent surgery, there was 1 treatment-related death, and the incidence of operative morbidity was similar to that in previous studies. According to RECIST, the overall response rate was 63% after CRT completion. Pathological complete response was achieved in 11 patients (44%) who underwent esophagectomy. Conclusions: NeoCRT was well tolerated and appears to be highly promising. The randomized controlled trial compared with neoadjuvant chemotherapy is needed and will be started.

PS02.108: EFFECTS OF PREOPERATIVE CHEMOTHERAPY FOR ADVANCED ESOPHAGEAL SQUAMOUS CELL CARCINOMA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 151-151
Author(s):  
Yukinori Kamio ◽  
Osamu Hachiya ◽  
Hiroto Fujimoto ◽  
Naoki Takasu ◽  
Makoto Toda ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Preoperative Chemotherapy ◽  
Squamous Cell ◽  
Clinical Stage ◽  
Pathological Response ◽  
Primary Site ◽  
Stage Ii ◽  
Pet Ct

Abstract Background In Japan, preoperative chemotherapy followed by surgery is the standard treatment for clinical stage II or III, excluding T4 thoracic esophageal squamous cell carcinoma (SCC). Here, we investigated the efficacy of preoperative chemotherapy in our hospital. Methods From January 2010 through December 2017, 33 patients with clinical stage II/III esophageal SCC underwent esophagectomy after preoperative chemotherapy with two cycles of cisplatin and 5-fluorouracil. Overall survival (OS) and clinical and pathological tumor responses were retrospectively evaluated. In addition, fluorodeoxyglucose (FDG) uptake was assessed by FDG-positron emission tomography/computed tomography (PET/CT). Results There were 9 patients with stage II and 24 with stage III esophageal SCC, and two cycles of chemotherapy were completed by 27 patients (81.8%). Three-year OS rates were 100% in patients with stage II and 66.7% in patients with stage III esophageal SCC, whose observation period exceeded beyond 3 years. Of the 33 patients who showed a clinical response at the primary site, 22 (66.7%) had a partial response (PR), and a 3-year OS of 85.7%, while 4 (12.1%) had a complete response (CR), and a 3-year OS of 100%. In regards to pathological response, as evaluated using The Japan Esophageal Society histological evaluation criteria, 3 patients (9.1%) were classified as grade 0, 18 (54.5%) as grade 1a, 4 (12.1%) as grade 1b, 6 (18.2%) as grade 2, and 2 (6.1%) as grade 3. Of the 22 patients who achieved PR, 14 (63.6%) were classified as either grade 0 or 1a. On the other hand, when we compared the maximum standardized uptake value (SUVmax) of FDG − PET/CT at the primary site before and after preoperative chemotherapy, the patients with high decreasing rates mostly belonged to the grade 1b-3 group. The OS rate tended to be higher in the grade 1b-3 group than in the grade 0–1a group. Conclusion Our present results suggest that, although pathological responses do not necessarily correspond to clinical tumor reduction, a good pathological response is potentially related to a better prognosis. Furthermore, the FDG uptake value may reflect pathological effects that occur owing to preoperative chemotherapy. Disclosure All authors have declared no conflicts of interest.

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