Concurrent chemoradiotherapy for locally advanced esophageal cancer - A pilot study by using daily low-dose cisplatin and continuous infusion of 5-fluorouracil
Journal
Anticancer Research
Journal Volume
19
Journal Issue
5 C
Pages
4463-4467
Date Issued
1999
Author(s)
Abstract
Background: Concurrent chemoradiotherapy (CCRT) has recently become a promising treatment for esophageal cancer. However, most investigators have adopted the conventional or modified Wayne-State PF (cisplatin plus 5-fluorouracil) regimen, which is inevitably associated with moderate to severe treatment-related toxicities. In this pilot study, we incorporated a daily low-dose regimen of cisplatin and 5-fluorouracil into CCRT in order to improve the compliance of the patients. Patients and Methods: Between July 1993 and Dec. 1997, 25 patients with locally advanced esophageal cancer (T3, or N1 disease), received CCRT which consisted of daily low-dose cisplatin (6 mg/m2/day) and continuous infusion of 5-FU (225 mg/m2/day) with radiotherapy (fraction size = 200-250 cGy/day). Except for the initial 9 patients, for whom post-CCRT esophagectomy was compulsory, all subsequent patients underwent esophagectomy only when inadequate response to CCRT was noted. The scheduled radiation dose was 50 Gy for the first 9 patients, and 60 Gy for the rest of the patients. Results: Eighteen patients (72%) completed the CCRT without interruption. Clinically, there were 8 CR and 9 PR, with a total response rate of 68% (47-87%, 95% C.I.). All patients were evaluable for toxicity. Grade 3/4 leukopenia and thrombocytopenia developed in 14 (56%) and 7 (28%) patients, respectively. Grade 3/4 non-hematologic toxicity was seen in 4 (16%) patients. The median survival of the whole group was 8 months (range: 2-59+). The projected 3-year overall survival was 24%. Conclusion: We suggest that for locally advanced esophageal cancer CCRT with the aforementioned daily low-dose regimen, is a treatment with good patient compliance.
SDGs
Other Subjects
antineoplastic metal complex; cisplatin; fluorouracil; pyrimidine antagonist; adult; advanced cancer; aged; article; cancer survival; clinical article; continuous infusion; esophagus cancer; female; human; leukopenia; male; multimodality cancer therapy; priority journal; radiation dose; thrombocytopenia; Adult; Aged; Aged, 80 and over; Antimetabolites, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell; Cisplatin; Esophageal Neoplasms; Female; Fluorouracil; Follow-Up Studies; Humans; Male; Middle Aged; Pilot Projects; Radiation-Sensitizing Agents; Survival Rate
Type
journal article