Abstract
Background
Patients with metastatic or recurrent esophageal squamous cell carcinoma (ESCC) have a poor prognosis. For decades, the most widely used first-line chemotherapy regimen for these patients has been the combination of 5-fluorouracil + cisplatin (CF). However, prognostic factors of CF as first-line chemotherapy for ESCC have not been clarified.
Methods
A total of 187 patients with metastatic or recurrent esophageal ESCC treated with CF at the National Cancer Center Hospital between January 2001 and December 2012 were enrolled in the study. The CF regimen comprised cisplatin (80 mg/m2) administered on day 1 and 5-fluorouracil (800 mg/m2) administered continuously on days 1–5, every 4 weeks. Multivariate Cox regression analysis was used to determine the potential prognostic factors.
Results
The median age of the patients was 62 (range 34–84) years. Metastasis and recurrence occurred in 116 and 71 of these patients, respectively. The overall response rate was 37.2%, with median progression-free and overall survival times of 4.8 and 10.4 months, respectively. In the multivariate analysis, higher serum C-reactive protein level and lower serum albumin level at the time of CF treatment initiation and number of metastatic sites were identified as independent prognostic factors for survival.
Conclusions
The results of this study corroborate previous findings on the efficacy of CF and will aid physicians in clinical decision-making and individual patient risk stratification, as well as in the further development of chemotherapy regimens.
Similar content being viewed by others
References
International Agency for Research on Cancer (IARC) GLOBOCAN 2012. http://globocan.iarc.fr/Pages/fact_sheets_population.aspx
Tachimori Y, Ozawa S, Numasaki H et al (2016) Comprehensive registry of esophageal cancer in Japan, 2009. Esophagus 13:110–137
Coonley CJ, Bains M, Hilaris B et al (1984) Cisplatin and bleomycin in the treatment of esophageal carcinoma. A final report. Cancer 54(11):2351–2355
Marcullo E, Alba E, de Segura GG (1988) Cisplatin and intravenous continuos infusion of bleomycin in advanced and metastatic esophageal cancer. Eur J Cancer Clin Oncol 24(4):633–635
Iizuka T, Kakegawa T, Ida H et al (1991) Phase II evaluation of combined cisplatin and vindecine in advanced squamous cell carcinoma of the esophagus. Jpn J Clin Oncol. 21(3):176–179
Dinwoodie WR, Bartolucci AA, Lyman GH et al (1986) Phase II evaluation of cisplatin, bleomycine in advanced squamous cell carcinoma of the esophagus. Cancer Treat Rep 70(2):267–270
Kok TC, Van der Gaast A, Dees J et al (1996) Cisplatin and etoposide in oesophageal cancer; a phase II study. Rotterdam Oesophageal Tumor Study Group. Br J Cancer 74(6):980–984
Bleiberg H, Conroy T, Paillot B et al (1997) Randomised phase II study of cisplatin and 5-fluorouracil (5-FU) versus cisplatin alone in advanced squamous cell oesophageal cancer. Eur J Cancer 33(8):1216–1220
Iizuka T, Kakegawa T, Ide H et al (1992) Phase II evaluation of cisplatin and 5-fluorouracil in advanced squamous cell carcinoma of the esophagus: Japan Esophageal Oncology Group Trial. Jpn J Clin Oncol 22:172–176
Hayashi K, Ando N, Watanabe H et al (2001) Phase II evaluation of protracted infusion of cisplatin and 5-fluorouracil in advanced squamous cell carcinoma of the esophagus: a Japan Esophageal Oncology Group Trial (JCOG9407). Jpn J Clin Oncol 31(9):419–423
Ando N, Kato H, Igaki H et al (2012) 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 19(1):68–74
Muro K, Hmaguchi T, Ohtsu A et al (2004) A phase II study of single-agent in phase with metastatic esophageal cancer. Ann Oncol 15(6):955–959
Kato K, Tahara M, Hironaka S et al (2011) A phase II study of paclitaxel by weekly 1-h infusion for advanced or recurrent esophageal cancer in patients who had previously received platinum-based chemotherapy. Cancer Chemother Pharmacol 67(6):1265–1272
Shirakawa T, Kato K, Nagashima K et al (2014) A retrospective study of docetaxel or paclitaxel in patients with advanced or recurrent esophageal squamous cell carcinoma who previously received fluoropyrimidine-and platinum-based chemotherapy. Cancer Chemother Pharmacol 74(6):1207–1215
Tamura S, Imano M, Takiuchi H et al (2012) Phase II study of docetaxel, cisplatin and 5-fluorouracil (DCF) for metastatic esophageal cancer (OGSG 0403). Anticancer Res 32:1403–1408
Osaka Y, Shinohara M, Hoshino S et al (2011) Phase II study of combined chemotherapy with docetaxel, CDDP and 5-FU for highly advanced esophageal cancer. Anticancer Res 31:633–638
Hironaka S, Tsubosa Y, Mizusawa J et al (2014) Phase I/II trial of 2-weekly docetaxel combined with cisplatin plus fluorouracil in metastatic esophageal cancer (JCOG0807). Cancer Sci 105(9):1189–1195
Kato K, Muro K, Ando A et al (2014) A phase II of nedaplatin and 5-fluorouracil in metastatic squamous cell carcinoma of the esophagus (JCOG9905-DI). Esophagus 11:183–188
Forrest LM, McMillan DC, McArdle CS et al (2003) Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer. Br J Cancer 89:1028–1030
Nozoe T, Ninomiya M, Maeda T et al (2010) Prognostic nutritional index: a tool to predict the biological aggressivenesss of gastric carcinoma. Surg Today 40:440–443
Maeda K, Shibutani M, Otani H et al (2014) Low nutritional prognostic index correlates with poor survival in patients with stage IV colorectal cancer following palliative resection of the primary tumor. World J Surg 38:1217–1222
Kanda M, Fujii T, Kodera Y et al (2011) Nutritional predictors of postoperative outcome in pancreatic cancer. Br J Surg 98:268–274
Masaichi O, Naoshi K, Go M et al (2015) Glasgow prognostic score as a prognostic clinical marker in T4 esophageal squamous cell carcinoma. Anticancer Res 35:4897–4902
Okuno T, Wakabayashi M, Kato K et al (2017) Esophageal stenosis and the Glasgow Prognostic Score as independent factors of poor prognosis for patients with locally advanced unresectable esophageal cancer treated with chemoradiotherapy (exploratory analysis of JCOG0303). Int J Clin Oncol 22(6):1042–1049
Acknowledgements
We gratefully thank Emiko Usami for data acquisition and Kengo Nagashima PhD for for statistical analysis.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors state that they have no conflict of interest.
About this article
Cite this article
Hiramoto, S., Kato, K., Shoji, H. et al. A retrospective analysis of 5-fluorouracil plus cisplatin as first-line chemotherapy in the recent treatment strategy for patients with metastatic or recurrent esophageal squamous cell carcinoma. Int J Clin Oncol 23, 466–472 (2018). https://doi.org/10.1007/s10147-018-1239-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10147-018-1239-x