Preoperative chemoradiotherapy with docetaxel, doxifluridine, and low-dose cisplatin for stage II/III squamous cell carcinoma of the esophagus

Preoperative chemotherapy using 5-fluorouracil and cisplatin is a standard treatment for stage II/III esophageal squamous cell carcinoma (ESCC) in Japan. However, stronger therapies are needed for advanced ESCC. This retrospective study aimed to evaluate the feasibility and safety of neoadjuvant chemoradiotherapy with R-DDP. Patients diagnosed with clinical stage II/III ESCC and initially treated with preoperative R-DDP were enrolled. R-DDP comprised intravenous docetaxel (40 mg m−2 day−1 on day 1), oral doxifluridine (800 mg m−2 day−1 on days 1–7), low-dose cisplatin (5 mg m−2 day−1 on days 1–5), and concurrent radiation (2 Gy day−1 on days 1–5), which were repeated weekly for 3 weeks (maximum total radiation: 30 Gy). If clinical stage T4 was suspected, another week of the regimen was added (maximum total radiation: 40 Gy). After therapy evaluation, patients underwent esophagectomy with 2 or 3 fields of lymphadenectomy. Between April 2003 and March 2011, 19 eligible patients were enrolled (treatment completion rate: 89.5 %). Complete or partial response was obtained in 17 cases (89.5 %), and 8 cases (42.1 %) involved downstaging. In resected specimens, the primary tumor’s histopathological grade was 1, 2, and 3 in 3, 11, and 5 cases. Although 42.1 % of patients developed grade 3+ adverse events, there were no severe perioperative complications. Three- and five-year overall survival rates were 42.1 and 36.1 %, with a 23-month median progression-free survival. Although this treatment had good antitumor effects, it did not necessarily confer prognostic improvements. R-DDP could become a therapeutic strategy for locally advanced ESCC.