Department of Surgery, Fujita Health University, Japan.
Department of Advanced Robotic and Endoscopic Surgery, Fujita Health University, Japan.
Intern Med. 2023;62(3):319-325. doi: 10.2169/internalmedicine.9751-22. Epub 2023 Feb 1.
Objective The aim of this study was to determine the safety and clinical efficacy of docetaxel+cisplatin+5-fluorouracil (DCF) as neoadjuvant chemotherapy (NAC). Methods In this single-center study, patient background and treatment outcomes (NAC efficacy assessment, NAC adverse events, short-term postoperative outcomes, and one-year postoperative outcomes) in patients treated with preoperative DCF and preoperative cisplatin+5-FU (CF) were compared retrospectively. Patients Seventeen patients diagnosed with esophageal squamous cell carcinoma (ESCC) and treated with preoperative DCF therapy and 50 patients treated with preoperative CF therapy between January 2013 and July 2019 were included in this study. Results There were significant differences in clinical T factor and clinical stage between the CF and DCF groups (p<0.05). All patients in the DCF therapy group were above clinical T3 and clinical stage III. The clinical response after NAC was partial response (PR) for 23 patients (46.0%) in the CF group and 13 patients (76.5%) in the DCF group (p=0.030). Regarding adverse events in NAC, neutropenia, febrile neutropenia (FN), diarrhea, and stomatitis were observed more frequently in the DCF group than in the CF group (p<0.05). The postoperative results [overall survival (OS), recurrence-free survival (RFS), one-year OS, one-year RFS] of the DCF group were comparable to those of the CF group. Conclusion DCF therapy has been recognized as an effective treatment option for advanced ESCC. However, the indication for DCF therapy should be chosen carefully because of the high incidence of adverse events.
目的 本研究旨在确定多西紫杉醇+顺铂+5-氟尿嘧啶(DCF)作为新辅助化疗(NAC)的安全性和临床疗效。
方法 本单中心研究回顾性比较了接受术前 DCF 治疗和术前顺铂+5-氟尿嘧啶(CF)治疗的患者的患者背景和治疗结局(NAC 疗效评估、NAC 不良事件、短期术后结局和 1 年术后结局)。
患者 本研究纳入了 2013 年 1 月至 2019 年 7 月期间诊断为食管鳞状细胞癌(ESCC)并接受术前 DCF 治疗的 17 例患者和接受术前 CF 治疗的 50 例患者。
结果 CF 组和 DCF 组在临床 T 因子和临床分期方面存在显著差异(p<0.05)。DCF 治疗组的所有患者均为临床 T3 以上和临床 III 期。CF 组的 NAC 后临床反应为部分缓解(PR)的患者有 23 例(46.0%),而 DCF 组为 13 例(76.5%)(p=0.030)。关于 NAC 的不良事件,DCF 组的中性粒细胞减少症、发热性中性粒细胞减少症(FN)、腹泻和口腔炎比 CF 组更常见(p<0.05)。DCF 组的术后结果[总生存(OS)、无复发生存(RFS)、1 年 OS、1 年 RFS]与 CF 组相当。
结论 DCF 治疗已被认为是晚期 ESCC 的有效治疗选择。然而,由于不良事件发生率较高,DCF 治疗的适应证应谨慎选择。