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Preoperative chemotherapy with weekly docetaxel plus low-dose cisplatin and 5-fluorouracil for stage II/III squamous cell carcinoma of the esophagus

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Abstract

Background

Docetaxel is a powerful anticancer agent for esophageal cancer. Preoperative combined chemotherapy with weekly docetaxel plus low-dose cisplatin and 5-fluorouracil (DFP) followed by surgery is expected to improve the survival of patients with resectable esophageal squamous cell carcinoma.

Methods

Clinical stage II/III squamous cell carcinoma patients who received DFP followed by esophagectomy (NAC group, n = 13) were compared retrospectively with patients who received surgery without preoperative DFP (Surgery group, n = 12). Not only the efficacy and toxicity of initial chemotherapy but also morbidity and survival after esophagectomy were assessed.

Results

Of 13 patients, the overall response rate was 92.3%; 30.8% (4/13) patients had CR, 61.5% (8/13) PR, 7.7% (1/13) SD, and 0 (0/13) PD. The 4 patients who achieved a pathological complete response (pCR) included 1 with cT4N1M0, 2 with cT3N1M0, and 1 with cT3N0M0. More than grade 3 toxicity of neutropenia and stomatitis occurred in 15.4% and 23.1% of patients, respectively. Leakage was 23.1% in the NAC group and 8.3% in the Surgery group. No treatment-related deaths occurred in the NAC group.

Conclusions

This regimen as preoperative chemotherapy seemed to provide a high response rate and a favorable survival benefit with acceptable toxicity and morbidity. To validate the clinical significance of this protocol, a randomized trial is essential.

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Authors and Affiliations

  1. Department of Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School, 2-50-1 Kuramoto-cho, Tokushima, 770-8503, Japan

    Takahiro Yoshida, Junichi Seike, Hiromichi Yamai, Hirokazu Takechi, Yasuhiro Yuasa, Yoshihito Furukita, Yota Yamamoto & Akira Tangoku

  2. Department of Surgery, Tokushima Municipal Hospital, Tokushima, Japan

    Takanori Miyoshi

  3. Department of Surgery, Higashiomiya General Hospital, Saitama, Japan

    Atsushi Umemoto

Authors
  1. Takahiro Yoshida
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  2. Junichi Seike
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  3. Takanori Miyoshi
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  4. Hiromichi Yamai
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  5. Hirokazu Takechi
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  7. Yoshihito Furukita
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  9. Atsushi Umemoto
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  10. Akira Tangoku
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Correspondence to Takahiro Yoshida.

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Yoshida, T., Seike, J., Miyoshi, T. et al. Preoperative chemotherapy with weekly docetaxel plus low-dose cisplatin and 5-fluorouracil for stage II/III squamous cell carcinoma of the esophagus. Esophagus 7, 95–100 (2010). https://doi.org/10.1007/s10388-010-0234-8

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  • DOI: https://doi.org/10.1007/s10388-010-0234-8

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