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Oral cryotherapy for prophylaxis of oral mucositis caused by docetaxel, cisplatin, and fluorouracil chemotherapy for esophageal cancer

  • Koichi Okamoto
  • Itasu NinomiyaEmail author
  • Takahisa Yamaguchi
  • Shiro Terai
  • Shinichi Nakanuma
  • Jun Kinoshita
  • Isamu Makino
  • Keishi Nakamura
  • Tomoharu Miyashita
  • Hidehiro Tajima
  • Hiroyuki Takamura
  • Sachio Fushida
  • Tetsuo Ohta
Original Article



Chemotherapy, including preoperative chemotherapy, plays an important role in the treatment of esophageal cancer. However, although docetaxel, cisplatin, and fluorouracil (DCF) therapy has a powerful antitumor effect, the associated adverse events make it difficult to maintain the patient’s general condition. Oral mucositis is an important adverse effect of chemotherapy, and its severity, frequency, and impact on patient quality of life should not be underestimated. This study evaluated the role of oral cryotherapy for prophylaxis of oral mucositis caused by DCF therapy.


We retrospectively examined the incidence and severity of adverse events, including mucositis, in 72 patients with esophageal cancer treated with DCF. Fifty-eight patients received cryotherapy during docetaxel administration and 14 received no cryotherapy.


The incidence of mucositis of all grades and grade 3 was significantly lower in the cryotherapy group compared with the no-cryotherapy group (24.1% vs. 71.4%, P < 0.001 and 0% vs. 28.6%, P = 0.001, respectively). The incidence of anorexia of all grades and grade 3 was also significantly lower in the cryotherapy group (22.4% vs. 57.1%, P = 0.037 and 0% vs. 28.6%, P = 0.010, respectively).


Adjunctive oral cryotherapy is effective for the prophylaxis and relief of oral mucositis and anorexia caused by chemotherapy.


Cryotherapy Esophageal cancer Oral mucositis Chemotherapy Adverse event 



The authors gratefully thank the nurses and pharmacists involved in the clinical practice. We also thank Susan Furness, PhD, from Edanz Group ( for editing a draft of this manuscript.

Compliance with ethical standards

Ethical Statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent or a substitute for it was obtained from all patients included in the study.

Conflict of interest

All authors declare no conflict of interest.


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Copyright information

© The Japan Esophageal Society and Springer 2019

Authors and Affiliations

  • Koichi Okamoto
    • 1
  • Itasu Ninomiya
    • 1
    Email author
  • Takahisa Yamaguchi
    • 1
  • Shiro Terai
    • 1
  • Shinichi Nakanuma
    • 1
  • Jun Kinoshita
    • 1
  • Isamu Makino
    • 1
  • Keishi Nakamura
    • 1
  • Tomoharu Miyashita
    • 1
  • Hidehiro Tajima
    • 1
  • Hiroyuki Takamura
    • 1
  • Sachio Fushida
    • 1
  • Tetsuo Ohta
    • 1
  1. 1.Department of Gastroenterological SurgeryKanazawa UniversityKanazawaJapan

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