Docetaxel, Cisplatin, and Fluorouracil Combination Chemotherapy in Neoadjuvant Treatment of Locally Advanced Esophageal Squamous Cell Carcinoma

摘要

Objective: Locally advanced (LA) esophagus squamous cell cancer (ESCC) is an aggressive tumor. Multimodal treatment options are being explored for ESCC. This study evaluated the efficacy and safety of docetaxel plus 5-fluorouracil and cisplatin (DCF) chemotherapy in LA ESCC. Material and Methods: Thirty-six patients with LA ESCC treated with DCF combination chemotherapy were retrospectively analyzed. Patients had received the DCF dosing scheme, involving docetaxel and cisplatin 75 mg/m2 on day 1 and fluorouracil 750 mg/m2 day on days 1-5, and this was repeated every three weeks. Results: The most common tumor location was the cervical esophagus (61%). T4 disease and lymph node involvement were observed in 56% and 84% of patients, respectively. After the neoadjuvant DCF application, most of the patients were treated with curative chemoradiotherapy (79%) and the remaining were operated on (17%). Clinical and objective response rates with neoadjuvant DCF applications were 75% and 59%, respectively. The median overall survival and progression-free survival was 37 (95% CI: 5-68) and 14 (95% CI: 6- 20) months, respectively. The 1- and 2-year survival rates were 70% and 50%, respectively. Treatment-related deaths were not observed. Grade 3-4 anemia (n=4, 11%), neutropenia (n=5, 14%), and thrombocytopenia (n=2, 5%) were the most common hematological toxicities in patients who were treated with classic DCF. Conclusion: Neoadjuvant DCF is a preferable combination of chemotherapy for young and fits LA ESCC patients.