Okamoto Hiroshi, Taniyama Yusuke, Sakurai Tadashi, Heishi Takahiro, Teshima Jin, Sato Chiaki, Maruyama Shota, Ito Ken, Onodera Yu, Konno-Kumagai Takuro, Ishida Hirotaka, Kamei Takashi
Department of Gastroenterological Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
Esophagus. 2018 Oct;15(4):281-285. doi: 10.1007/s10388-018-0627-7. Epub 2018 Jun 15.
Recently, definitive chemoradiotherapy (dCRT) has become one of the essential treatment strategies for esophageal squamous cell carcinoma (ESCC) and has been especially gaining prevalence for cervical ESCC to preserve the larynx. Our department recently introduced dCRT concomitant with docetaxel, cisplatin, and 5-fluorouracil (DCF-R) for treating advanced cervical ESCC. This study aims to assess the safety and outcomes of DCF-R in patients with advanced cervical ESCC.
We retrospectively assessed 11 patients with advanced cervical ESCC (clinical stage: II-IV, including T4b and/or M1 lymph node) who received DCF-R as the first-line treatment between December 2010 and February 2015.
Our patient cohort comprised 8 males and 3 females (median age 68 years; range 54-76 years). The pretreatment clinical stage included stage II (1), stage III (7), and stage IV (3) cases [including 3 patients with T4b (2 trachea and 1 thyroid) and 3 patients with M1 lymph node]. We attained complete response (CR) in 10 patients and stable disease in 1 patient. Of 10 patients with CR, 5 experienced recurrence and 5 continued exhibiting CR. Furthermore, grade 3 or more adverse events included leucopenia (91%), neutropenia (91%), febrile neutropenia (45%), and pharyngeal pain (55%). While the 2-year overall survival rate was 72%, the 2-year recurrent-free survival rate was 64%, respectively.
DCF-R treatment for advanced cervical esophageal cancer could be completed by the careful administration; although a strong blood toxicity might occur, this treatment may provide the chance to obtain favorable prognosis with larynx preservation.
最近，确定性放化疗（dCRT）已成为食管鳞状细胞癌（ESCC）的重要治疗策略之一，尤其在保留喉功能的颈段ESCC治疗中越来越普遍。我们科室最近引入了多西他赛、顺铂和5-氟尿嘧啶联合的dCRT（DCF-R）来治疗晚期颈段ESCC。本研究旨在评估DCF-R治疗晚期颈段ESCC患者的安全性和疗效。
我们回顾性评估了2010年12月至2015年2月期间接受DCF-R作为一线治疗的11例晚期颈段ESCC患者（临床分期：II-IV期，包括T4b和/或M1淋巴结转移）。
我们的患者队列包括8名男性和3名女性（中位年龄68岁；范围54-76岁）。治疗前临床分期包括II期（1例）、III期（7例）和IV期（3例）[包括3例T4b患者（2例侵犯气管和1例侵犯甲状腺）和3例M1淋巴结转移患者]。10例患者达到完全缓解（CR），1例患者病情稳定。在10例CR患者中，5例复发，5例持续保持CR。此外，3级及以上不良事件包括白细胞减少（91%）、中性粒细胞减少（91%）、发热性中性粒细胞减少（45%）和咽痛（55%）。2年总生存率为72%，2年无复发生存率分别为64%。
通过谨慎给药可完成DCF-R治疗晚期颈段食管癌；尽管可能会出现严重的血液毒性，但这种治疗可能为保留喉功能并获得良好预后提供机会。
