1. Downstaging and Histological Effects Might Be Reliable Predictors of the Efficacy of DOC+CDDP+5-FU (DCF) as Neoadjuvant Therapy for Stage III or Borderline Resectable Esophageal Cancer: a Single Institute Experience.
- Author
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Kobayashi K, Kanetaka K, Yoneda A, Kobayashi S, Maruya Y, Isagawa Y, Yoshimoto T, Migita K, Kawaguchi Y, Kuba S, Morita M, Okada S, Kosaka T, Yamaguchi S, Inoue Y, Adachi T, Hidaka M, Torashima Y, Ito S, Takatsuki M, and Eguchi S
- Subjects
- Aged, Cisplatin administration & dosage, Disease-Free Survival, Docetaxel administration & dosage, Drug Administration Schedule, Esophageal Mucosa diagnostic imaging, Esophageal Mucosa drug effects, Esophageal Mucosa pathology, Esophageal Mucosa surgery, Esophageal Neoplasms diagnosis, Esophageal Neoplasms mortality, Esophageal Squamous Cell Carcinoma diagnosis, Esophageal Squamous Cell Carcinoma mortality, Esophageal Squamous Cell Carcinoma pathology, Esophagectomy, Esophagoscopy, Feasibility Studies, Female, Fluorouracil administration & dosage, Follow-Up Studies, Humans, Japan epidemiology, Male, Middle Aged, Neoplasm Recurrence, Local prevention & control, Neoplasm Staging, Pyrimidines, Retrospective Studies, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Esophageal Neoplasms therapy, Esophageal Squamous Cell Carcinoma therapy, Neoadjuvant Therapy methods, Neoplasm Recurrence, Local epidemiology
- Abstract
Purpose: In Japan, two courses of CDDP+5-FU (CF) therapy followed by surgery are accepted as a standard treatment for stage II/III esophageal cancer (EC) based on the results of the JCOG9907 trial. To gain a better survival, benefit especially for stage III patients in comparison with CF therapy, a three-arm phase III trial (neoadjuvant setting: CF vs. CF + radiation vs. DOC+CF [DCF]) is ongoing. We have aggressively performed DCF therapy for stage III or IV patients since October 2014. We herein review the outcomes of DCF therapy., Methods: We retrospectively reviewed the cases of 27 patients with stage III or IV EC (male, n = 24; female, n = 3; median age, 70.0 years) who received DCF therapy., Results: The response rate was 48.1%. Downstaging was achieved over the course of treatment in 14 patients (51.9%). Twenty-six patients transitioned to surgery, with 25 receiving R0 resection. DCF-treated patients who achieved downstaging showed significantly longer relapse-free survival (RFS) than those without downstaging (p = 0.0002). DCF-treated patients with a grade ≥ 1b histological effect showed significantly longer RFS than those with a grade < 1b effect (p = 0.0282). The multivariate analysis showed that downstaging was the only factor significantly associated with RFS in DCF-treated patients., Conclusions: DCF therapy for stage ≥ III esophageal carcinoma is both feasible and effective. These findings suggest that downstaging and the histological effect might predict the effects of DCF therapy for EC.
- Published
- 2021
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