Department of Medical Oncology, Dr. B Borooah Cancer Institute, Guwahati, Assam, India.
Department of Surgical Oncology, Dr. B Borooah Cancer Institute, Guwahati, Assam, India.
J Egypt Natl Canc Inst. 2021 Oct 21;33(1):35. doi: 10.1186/s43046-021-00094-0.
Squamous cell carcinoma of the esophagus ranks as the most common cause of cancer incidence and mortality in males and the second most common in females. Surgery alone is associated with poor long-term survival. Neoadjuvant chemoradiation and perioperative chemotherapy without radiation have been tried to improve survival rates.
We retrospectively evaluated the neoadjuvant chemotherapy in forty-eight patients with non-metastatic, non-cervical squamous cell carcinoma of the esophagus with a docetaxel-based three-drug regimen to improve complete pathological response rates.
The median age of presentation was 52 years, with male preponderance. All the patients received three cycles of docetaxel-cisplatin-fluorouracil-based chemotherapy. A complete pathological response to neoadjuvant chemotherapy was seen in 8 patients (17%). Rates of grade 3 hematological toxicities were seen in 12% of patients, with no observed grade 4 toxicity. The most common non-hematological toxicity was grade 3 alopecia (seen in 40%) and grade 2 nausea/vomiting in 8% of patients. At a median follow-up of 26.5 months, 2-year survival for the patients receiving chemotherapy and surgery is 66%.
Preoperative chemotherapy with a taxane-based triple-drug regimen is a reasonable approach in squamous cell carcinoma of the esophagus, associated with improvement in complete pathological response rates, increases complete resection rates, with manageable toxicity.
食管鳞状细胞癌是男性癌症发病率和死亡率最高的原因,也是女性第二大常见原因。单独手术与长期生存预后不良相关。新辅助放化疗和不伴放疗的围手术期化疗已被尝试用于提高生存率。
我们回顾性评估了 48 例非转移性、非颈段食管鳞状细胞癌患者接受以多西紫杉醇为基础的三药方案新辅助化疗,以提高完全病理缓解率。
中位发病年龄为 52 岁,男性居多。所有患者均接受了三个周期的多西紫杉醇-顺铂-氟尿嘧啶为基础的化疗。8 例(17%)患者对新辅助化疗有完全病理缓解。3 级血液学毒性发生率为 12%,无 4 级毒性。最常见的非血液学毒性是 3 级脱发(40%)和 2 级恶心/呕吐(8%)。在中位随访 26.5 个月时,接受化疗和手术的患者 2 年生存率为 66%。
以紫杉烷为基础的三药方案术前化疗是食管鳞状细胞癌的一种合理治疗方法,可提高完全病理缓解率,增加完全切除率,毒性可管理。