Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan;
Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
Anticancer Res. 2022 Aug;42(8):3905-3911. doi: 10.21873/anticanres.15884.
BACKGROUND/AIM: To further improve the prognosis of locally advanced esophageal cancer patients, investigating new perioperative treatment strategies is necessary. The current study aimed to retrospectively investigate neoadjuvant radiotherapy with cisplatin and 5-fluorouracil (CF-RT) and radiotherapy with docetaxel and CF (DCF-RT) and compare their treatment outcomes in patients with locally advanced esophageal squamous cell carcinoma (ESCC).
We retrospectively reviewed 95 patients with ESCC who received CF-RT or DCF-RT followed by esophagectomy. The CF-RT group received chemotherapy consisting of two courses of CF repeated every 4 weeks. The DCF-RT group received chemotherapy consisting of two courses of DCF repeated every 2 weeks. A radiotherapy dose of 1.8-2 Gy was administered per session, up to a total of 40-41.4 Gy. Adverse events of neoadjuvant chemoradiotherapy, surgical outcomes, pathological responses, prognosis, and recurrence patterns were evaluated.
Both the CF-RT and DCF-RT groups had equivalent pathological complete response rates of the primary tumor at 31.6% and 38.6%, respectively. However, the DCF-RT group had significantly better 5-year disease-free survival and 5-year overall survival than (HR=0.50, 95%CI=0.26-0.97, p=0.0392) than the CF-RT group.
DCF-RT may be a candidate neoadjuvant therapy for locally advanced ESCC.
背景/目的:为进一步改善局部晚期食管癌患者的预后,有必要探索新的围手术期治疗策略。本研究旨在回顾性研究顺铂和 5-氟尿嘧啶(CF-RT)新辅助放疗和多西紫杉醇与 CF(DCF-RT)放疗在局部晚期食管鳞状细胞癌(ESCC)患者中的治疗效果。
我们回顾性分析了 95 例接受 CF-RT 或 DCF-RT 后行食管切除术的 ESCC 患者。CF-RT 组接受 CF 两个疗程化疗,每 4 周重复一次。DCF-RT 组接受 CF 两个疗程化疗,每 2 周重复一次。每次放疗剂量为 1.8-2 Gy,总剂量为 40-41.4 Gy。评估新辅助放化疗的不良反应、手术结果、病理反应、预后和复发模式。
CF-RT 组和 DCF-RT 组的原发肿瘤病理完全缓解率分别为 31.6%和 38.6%,两组相似。然而,DCF-RT 组的 5 年无病生存率和 5 年总生存率明显优于 CF-RT 组(HR=0.50,95%CI=0.26-0.97,p=0.0392)。
DCF-RT 可能是局部晚期 ESCC 的一种新辅助治疗候选方案。