Published in:
01-07-2014 | Original Article
Neoadjuvant chemotherapy using concurrent Docetaxel/CDDP/5-FU (DCF) in esophageal squamous cell carcinoma and its short-term prognosis
Published in: Esophagus | Issue 3/2014
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Background
Our aim in this study is to know whether clinical outcomes are improved by neoadjuvant chemotherapy (NAC) using Docetaxel/CDDP/5-FU (DCF) as compared to NAC using 5-FU/CDDP (FP).
Methods
Thirty-eight patients who underwent DCF NAC in cStage II/III esophageal squamous cell carcinoma (ESCC) were compared with the 41 counterparts treated by FP NAC. Docetaxel and CDDP were both given to 70–75 mg/m2 with concurrent 5-FU at 750 mg/m2 in 3 cycles. Median follow-up term of DCF NAC reached 27 months.
Results
In DCF NAC, grade 3 adverse effects were recognized in 97 %, and completion rate of the DCF NAC was 86 %. In terms of PR + CR rate, DCF NAC was better (87 %) than FP NAC (59 %) (p = 0.005). Five year progression-free survival (PFS) and overall survival (OS) of FP NAC were 32 and 69 %, respectively, and OS of FP NAC was excellent putatively due to adoption of definitive chemoradiation therapy for recurrent diseases. Furthermore, survival was in favor of DCF NAC as compared to FP NAC for OS (p = 0.02) and PFS (p = 0.10), while R0 resection rate was similar. The 1st multivariate prognostic analysis among all cases with NAC revealed that significant factors were resectability and NAC modality for OS and PFS. We then performed the 2nd stage multivariate prognostic analysis limited to R0 cases including pathologic factors, which again identified DCF NAC modality as an independent prognostic factor.
Conclusion
DCF NAC for ESCC demonstrated high response rates, and may improve patient survival with acceptable feasibility.