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Cancer Chemotherapy and Pharmacology

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01-06-2012 | Original Article

Neoadjuvant chemoradiotherapy with docetaxel, cisplatin, and 5-fluorouracil for esophageal cancer

Authors: Manabu Emi, Jun Hihara, Yoichi Hamai, Yoshiro Aoki, Morihito Okada, Masahiro Kenjo, Yuji Murakami

Published in: Cancer Chemotherapy and Pharmacology | Issue 6/2012

Abstract

Purpose

We aimed to evaluate the safety, tolerability, and efficacy of combination preoperative chemoradiotherapy as first-line treatment in patients with advanced esophageal cancer.

Methods

We performed a phase I dose-escalation trial of docetaxel at 25–40 mg/m² in four planned dose levels in 3–6 patient cohorts on days 1, 15, 29, and 43 administered in combination with cisplatin (70 mg/m² on days 1 and 29) and 5-fluorouracil (70 mg/m²/day on days 1–4 and 29–32) and concurrent radiation therapy (40 Gy). The tumors were resected during weeks 10–13.

Results

This study included 7 patients with esophageal cancer. The dose-limiting toxicity was observed at a biweekly docetaxel dose of 30 mg/m² when patients developed grade 3 febrile neutropenia, grade 4 thrombocytopenia, and grade 4 pain/esophagus, resulting in a maximum tolerated dose of 25 mg/m². Grade 3/4 hematological toxicity was observed in 71% of the patients and grade 3/4 non-hematological toxicity in 57%. The overall tumor response rate was 86% (complete, 57% and partial, 29%). All patients underwent surgery, and there were no deaths as a result of postoperative complications.

Conclusions

This preoperative chemoradiotherapy regimen using triplets is feasible but results in moderate toxicity. It is noteworthy that this regimen was associated with a high rate of pathological complete remission.

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Title: Neoadjuvant chemoradiotherapy with docetaxel, cisplatin, and 5-fluorouracil for esophageal cancer
Authors: Manabu Emi
Jun Hihara
Yoichi Hamai
Yoshiro Aoki
Morihito Okada
Masahiro Kenjo
Yuji Murakami
Publication date: 01-06-2012
Publisher: Springer-Verlag
Published in: Cancer Chemotherapy and Pharmacology / Issue 6/2012
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI: https://doi.org/10.1007/s00280-012-1853-7

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Abstract

Purpose

Methods

Results

Conclusions

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