Department of General Surgical Science, Graduate School of Medicine, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.
Department of Innovative Cancer Immunotherapy, Gunma University Graduate School of Medicine, Maebashi, Japan.
Cancer Chemother Pharmacol. 2019 Jun;83(6):1121-1126. doi: 10.1007/s00280-019-03835-0. Epub 2019 Apr 9.
To evaluate the efficacy of docetaxel, cisplatin, and 5-fluorouracil as combination chemoradiotherapy (DCF-RT) for cervical esophageal cancer (CEC), we performed a retrospective analysis of CEC patients treated by DCF-RT at a single institution.
We conducted a single-center retrospective study. Twenty-one patients with CEC who underwent DCF-RT between 1999 and 2017 at our institute were included in this study. Chemotherapy consisted of intravenous docetaxel at 50 mg/m on day 1, intravenous CDDP at 60 mg/m on day 1, and intravenous 5-FU at 600 mg/m on days 1-4, repeated every 4 weeks for two cycles. Among the 21 patients, six were irradiated using three-dimensional conformal RT (3D- conformal RT) and 15 were treated using intensity-modulated RT (IMRT) consisting of 60 Gy in 30 fractions.
The median follow-up period was 49.6 months (range 4.6-97.6). The overall complete response (CR) and local CR rates were 61.9% and 81.0% for all patients, and 76.9% and 84.6% for patients without hypopharyngeal and/or thoracic esophageal invasion, respectively. The 3-year overall survival (OS), progression-free survival (PFS), and local failure-free survival (LFFS) rates were 79.6, 52.4, and 74.7%, respectively. Grade 3-4 leucopenia developed in 12 patients (70.6%), neutropenia developed in 13 patients (81.2%), and mucositis developed in 2 patients (9.5%). There were no treatment-related deaths.
The 3-year OS and LFFS of patients who underwent DCF-RT were higher than those in the previous studies. Although the high rate of myelosuppression requires careful management, DCF-RT is a safe and effective modality for CEC.
为了评估多西他赛、顺铂和 5-氟尿嘧啶联合放化疗（DCF-RT）在颈段食管癌（CEC）中的疗效，我们对单中心接受 DCF-RT 治疗的 CEC 患者进行了回顾性分析。
我们进行了一项单中心回顾性研究。纳入了 1999 年至 2017 年期间在我院接受 DCF-RT 的 21 例 CEC 患者。化疗方案为多西他赛 50mg/m2，第 1 天静脉滴注；顺铂 60mg/m2，第 1 天静脉滴注；5-氟尿嘧啶 600mg/m2，第 1-4 天静脉滴注，每 4 周重复 2 个周期。21 例患者中，6 例接受三维适形放疗（3D- conformal RT），15 例接受调强放疗（IMRT），总剂量 60Gy，分割 30 次。
中位随访时间为 49.6 个月（范围 4.6-97.6）。所有患者的总体完全缓解（CR）和局部 CR 率分别为 61.9%和 81.0%，无下咽和/或胸段食管侵犯的患者分别为 76.9%和 84.6%。3 年总生存率（OS）、无进展生存率（PFS）和局部无失败生存率（LFFS）分别为 79.6%、52.4%和 74.7%。12 例（70.6%）患者出现 3-4 级白细胞减少，13 例（81.2%）患者出现中性粒细胞减少，2 例（9.5%）患者出现粘膜炎。无治疗相关死亡。
接受 DCF-RT 的患者 3 年 OS 和 LFFS 高于既往研究。虽然骨髓抑制发生率较高需要谨慎管理，但 DCF-RT 是 CEC 的一种安全有效的治疗方式。
