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

Yoshida, Takahiro; Seike, Junichi; Miyoshi, Takanori; Yamai, Hiromichi; Takechi, Hirokazu; Yuasa, Yasuhiro; Furukita, Yoshihito; Yamamoto, Yota; Umemoto, Atsushi; Tangoku, Akira

doi:10.1007/s10388-010-0234-8

Cited by 20 publications

(5 citation statements)

References 23 publications

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“…There were no patients whose operation was postponed or who had increased operative complications related to chemotherapy, despite the observed severe adverse events after chemotherapy. No severe postoperative complication was observed, and the complication rates were not significantly different from those described in other reports [60% vs. 55.6%, 61.5%] [21,22]. Response rates were higher than other FP-based regimens, and the DCF regimen appeared to be beneficial for patients who had extensive locoregional LN metastases.…”

Section: Discussioncontrasting

confidence: 55%

Efficacy and safety of docetaxel/cisplatin/5-fluorouracil preoperative combination chemotherapy in esophageal cancer patients with extended lymph node metastases

et al. 2012

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Aim We retrospectively investigated the efficacy and safety of combination chemotherapy with 5-fluorouracil (5-FU) and cisplatin plus docetaxel (DCF) as preoperative chemotherapy. Methods One hundred and seven patients were diagnosed with esophageal cancer of clinical stage II and III (except T4) from March 2007 to June 2009. Among these, five patients who had extensive locoregional lymph node metastases underwent preoperative DCF chemotherapy. Results Median age of the five patients was 59 (51-67) years, and all were men with clinical stage III esophageal cancer. The best overall responses were 80% with partial response (PR) and 20% with stable disease (SD). Histological response of grade 1b and more was also 80%. The hematologic toxicities included grade 3 leucopenia in 80% of patients; grade 3 or 4 neutropenia was observed in all patients. Febrile neutropenia occurred in 20% of patients. Nonhematologic toxicities included grade 3 anorexia in 80% of patients. The operations were not postponed due to any adverse events. Postoperative complications included pneumonia, pneumothorax, and cervical lymphatic leakage (one case each). No chemotherapy-related postoperative complications were observed. Median follow-up of surviving patients was 51.5 (33.9-56.4) months. Disease-free survival times were 12.1, 30.9, 48.0, 49.0, and 54.0 months, respectively. Overall survival times were 28.9, 33.9, 51.0, 52.1, and 56.4 months, respectively. Conclusions The response rate of preoperative DCF was 80%, and toxicities were tolerated with support therapies such as granulocyte colony-stimulating factor (G-CSF) and dexamethasone. We therefore concluded that this preoperative treatment might be a promising strategy for patients who have extensive regional lymph node metastases.

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Section: Discussioncontrasting

confidence: 55%

Efficacy and safety of docetaxel/cisplatin/5-fluorouracil preoperative combination chemotherapy in esophageal cancer patients with extended lymph node metastases

et al. 2012

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“…Cisplatin plus docetaxel, with or without 5-FU, has demonstrated activity in patients with locally advanced EGI or metastatic esophageal SCC [ 52 - 54 ]. A small-sample retrospective study has also showed that preoperative combined CT with docetaxel plus cisplatin and 5-FU followed by surgery provided a high response rate and a favorable survival benefit in patients with resectable esophageal SCC [ 55 ]. In the docetaxel plus cisplatin and 5-FU group, the overall response rate was 92.3%; 30.8% patients had complete response, 61.5% partial response, 7.7% stable disease, and 0 progressive disease.…”

Section: Discussionmentioning

confidence: 99%

Neoadjuvant versus adjuvant treatment: which one is better for resectable esophageal squamous cell carcinoma?

Chen

et al. 2012

World J Surg Onc

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Esophageal cancer is the eighth most common cancer worldwide, and especially in some areas of China is the fourth most common cause of death and is of squamous cell carcinoma (SCC) histology in >90% of cases. Surgery alone was the mainstay of therapeutic intervention in the past, but high rates of local and systemic failure have prompted investigation into multidisciplinary management. In this review, we discuss the key issues raised by the recent availability of esophageal SCC treatment with the addition of chemotherapy, radiotherapy, and chemoradiotherapy to the surgical management of resectable disease and discuss how clinical trials and meta-analysis inform current clinical practice. None of the randomized trials that compared neoadjuvant radiotherapy or chemotherapy with surgery alone in esophageal SCC has demonstrated an increase in overall survival in those patients treated with neoadjuvant radiotherapy or chemotherapy. Neoadjuvant chemoradiotherapy has been accepted recently for esophageal cancer because such a regimen offers great opportunity for margin negative resection, improved loco-regional control and increased survival. The majority of the available evidence currently reveals that only selected locally advanced esophageal SCC are more likely to benefit from the adjuvant therapy. The focus of future trials should be on identification of the optimum regimen and should aim to minimize treatment toxicities and effect on quality of life, as well as attempt to identify and select those patients most likely to benefit from specific treatment options.

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“…4). 30) Recently, our data showed that patients with positive EGFR had a poor prognosis without chemotherapy; however, the prognosis had improved with NAC. EGFR is a predictive factor in the patient's prognosis and response to chemotherapy, and HER2 and HER3 also show similar behaviors.…”

Section: New Therapeutic Strategy For Stage II Iii Esophageal Cancermentioning

confidence: 95%

The New Era of Staging as a Key for an Appropriate Treatment for Esophageal Cancer

Tangoku

Yamamoto

Furukita

et al. 2012

Ann Thorac Cardiovasc Surg

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Fluorodeoxyglucose-positron emission tomography (FDG-PET) and computed tomography (CT) have become the gold standard for staging of esophageal cancer by detecting distant metastases, but metastatic lymph nodes are often difficult to diagnose from the size and standardized uptake value (SUV). If we compare the diagnostic performance of endoscopic ultrasonography (EUS), CT, and FDG-PET in staging of esophageal cancer, EUS is the most sensitive method to identify the detection of regional lymph node metastases, whereas CT and FDG-PET are more specific tests. Combination study with CT, EUS and PETCT cannot make a precise diagnosis after neoadjuvant therapy (NAT). A precise staging might be determined by the fine needle aspiration biopsy (FNAB) under EUS and US screening in the neck and the abdomen even after NAT. Indication of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for superficial cancer is sensitive because of difficulty in T1b cancer diagnosis. Detailed examination about vessel invasion and the possibility of residual tumor with dissected specimen will offer an appropriate additional therapy. New strategy like sentinel lymph node (SLN) navigation could supply more information about lymphatic routes and metastatic nodes. SLN navigation with ESD might become a new less invasive strategy for superficial esophageal cancer.

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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

Cited by 20 publications

References 23 publications

Efficacy and safety of docetaxel/cisplatin/5-fluorouracil preoperative combination chemotherapy in esophageal cancer patients with extended lymph node metastases

Efficacy and safety of docetaxel/cisplatin/5-fluorouracil preoperative combination chemotherapy in esophageal cancer patients with extended lymph node metastases

Neoadjuvant versus adjuvant treatment: which one is better for resectable esophageal squamous cell carcinoma?

The New Era of Staging as a Key for an Appropriate Treatment for Esophageal Cancer

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