Concurrent Chemoradiotherapy with Docetaxel, Cisplatin, and 5-fluorouracil Improves Survival of Patients with Advanced Esophageal Cancer Compared with Conventional Concurrent Chemoradiotherapy with Cisplatin and 5-fluorouracil

Tamaki, Yukihisa; Hieda, Yoko; Nakajima, Masanobu; Kitajima, Kazuhiro; Yoshida, Rika; Yoshizako, Takeshi; Ue, Atsushi; Tokudo, Mutsumi; Hirahara, Noriyuki; Moriyama, Ichiro; Kato, Hiroyuki; Inomata, Taisuke

doi:10.7150/jca.23456

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J Cancer 2018; 9(16):2765-2772. doi:10.7150/jca.23456 This issue Cite

Research Paper

Concurrent Chemoradiotherapy with Docetaxel, Cisplatin, and 5-fluorouracil Improves Survival of Patients with Advanced Esophageal Cancer Compared with Conventional Concurrent Chemoradiotherapy with Cisplatin and 5-fluorouracil

Yukihisa Tamaki¹, Yoko Hieda¹, Masanobu Nakajima², Kazuhiro Kitajima³, Rika Yoshida⁴, Takeshi Yoshizako⁴, Atsushi Ue¹, Mutsumi Tokudo¹, Noriyuki Hirahara⁵, Ichiro Moriyama⁶, Hiroyuki Kato², Taisuke Inomata^1✉

1. Department of Radiation Oncology, Shimane University Faculty of Medicine
2. Department of Surgery I, Dokkyo Medical University
3. Department of Radiology, Division of Nuclear Medicine and PET Center, Hyogo College of Medicine
4. Department of Radiology, Shimane University Faculty of Medicine
5. Department of Digestive and General Surgery, Shimane University Faculty of Medicine
6. Division of Cancer Center, Shimane University Hospital

Citation:

Tamaki Y, Hieda Y, Nakajima M, Kitajima K, Yoshida R, Yoshizako T, Ue A, Tokudo M, Hirahara N, Moriyama I, Kato H, Inomata T. Concurrent Chemoradiotherapy with Docetaxel, Cisplatin, and 5-fluorouracil Improves Survival of Patients with Advanced Esophageal Cancer Compared with Conventional Concurrent Chemoradiotherapy with Cisplatin and 5-fluorouracil. J Cancer 2018; 9(16):2765-2772. doi:10.7150/jca.23456. https://www.jcancer.org/v09p2765.htm

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Abstract

Purpose: To compare treatment outcomes and adverse events between concurrent chemoradiotherapy with docetaxel, cisplatin, and 5-fluorouracil (DCF-RT) and conventional concurrent chemoradiotherapy with cisplatin and 5-fluorouracil (CF-RT).

Methods and Materials: We retrospectively investigated treatment outcomes and adverse events in 121 patients with advanced esophageal cancer who underwent concurrent chemoradiotherapy with CF-RT (n = 83) or DCF-RT (n = 38). In the CF-RT group, patients were administered cisplatin (70 mg/m²) and 5-fluorouracil (700 mg/m²) for 5 days; in the DCF-RT group, patients were administered docetaxel (50 mg/m²), cisplatin (50 mg/m²), and 5-fluorouracil (500 mg/m²) for 5 days. The radiotherapy dose was 1.8-2 Gy per session, up to a total of 50-60 Gy.

Results: The complete response (CR) rate was 37.8% in the CF-RT group and 52.6% in the DCF-RT group. Overall survival (OS) rates at 2 and 3 years were 45.0% and 37.5%, respectively, in the CF-RT group and 62.9% and 56.7%, respectively, in the DCF-RT group, with a significant intergroup difference (p = 0.032). Progression-free survival rates at 2 and 3 years were 44.1% and 36.9%, respectively, in the CF-RT group and 45.0% and 45.0%, respectively, in the DCF-RT group (p = 0.10). Local control rates at 2 and 3 years were 59.1% and 54.6%, respectively, in the CF-RT group and 71.8% and 71.8%, respectively, in the DCF-RT group (p = 0.12). The incidence of Grade 3/4 leukopenia was 55.4% (n = 46) in the CF-RT group and 78.9% (n = 30) in the DCF-RT group, with a significant intergroup difference (p = 0.022). The incidence of Grade 3/4 neutropenia was 47.0% (n = 39) in the CF-RT group and 65.8% (n = 25) in the DCF-RT group, with a notable albeit not statistically significant difference between the groups (p = 0.054). There were no significant intergroup differences in anemia, thrombocytopenia, radiation-induced dermatitis, radiation esophagitis, or late adverse events.

Conclusions: Rates of OS and CR were improved after treatment with DCF-RT compared with CF-RT. Although DCF-RT-treated patients had higher rates of leukopenia, treatment safety was ensured through proper management of myelotoxicity. DCF-RT is a promising treatment regimen for advanced esophageal cancer.

Keywords: esophageal cancer, concurrent chemoradiotherapy, docetaxel, cisplatin, 5-fluorouracil, overall survival

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APA

Tamaki, Y., Hieda, Y., Nakajima, M., Kitajima, K., Yoshida, R., Yoshizako, T., Ue, A., Tokudo, M., Hirahara, N., Moriyama, I., Kato, H., Inomata, T. (2018). Concurrent Chemoradiotherapy with Docetaxel, Cisplatin, and 5-fluorouracil Improves Survival of Patients with Advanced Esophageal Cancer Compared with Conventional Concurrent Chemoradiotherapy with Cisplatin and 5-fluorouracil. Journal of Cancer, 9(16), 2765-2772. https://doi.org/10.7150/jca.23456.

ACS

Tamaki, Y.; Hieda, Y.; Nakajima, M.; Kitajima, K.; Yoshida, R.; Yoshizako, T.; Ue, A.; Tokudo, M.; Hirahara, N.; Moriyama, I.; Kato, H.; Inomata, T. Concurrent Chemoradiotherapy with Docetaxel, Cisplatin, and 5-fluorouracil Improves Survival of Patients with Advanced Esophageal Cancer Compared with Conventional Concurrent Chemoradiotherapy with Cisplatin and 5-fluorouracil. J. Cancer 2018, 9 (16), 2765-2772. DOI: 10.7150/jca.23456.

NLM

CSE

Tamaki Y, Hieda Y, Nakajima M, Kitajima K, Yoshida R, Yoshizako T, Ue A, Tokudo M, Hirahara N, Moriyama I, Kato H, Inomata T. 2018. Concurrent Chemoradiotherapy with Docetaxel, Cisplatin, and 5-fluorouracil Improves Survival of Patients with Advanced Esophageal Cancer Compared with Conventional Concurrent Chemoradiotherapy with Cisplatin and 5-fluorouracil. J Cancer. 9(16):2765-2772.

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