Definitive chemoradiotherapy with docetaxel, cisplatin, and 5-fluorouracil (DCF-R) for advanced cervical esophageal cancer
Definitive chemoradiotherapy with docetaxel, cisplatin, and 5-fluorouracil (DCF-R) for advanced cervical esophageal cancer
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DOI：
10.1007/s10388-018-0627-7
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发表时间：
2018-06
期刊：
影响因子：
2.4
通讯作者：
H. Okamoto;Y. Taniyama;T. Sakurai;Takahiro Heishi;J. Teshima;C. Sato;Shota Maruyama;Ken Ito;Y. Onodera;T. Konno-Kumagai;H. Ishida;T. Kamei
中科院分区：
文献类型：
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作者：
H. Okamoto;Y. Taniyama;T. Sakurai;Takahiro Heishi;J. Teshima;C. Sato;Shota Maruyama;Ken Ito;Y. Onodera;T. Konno-Kumagai;H. Ishida;T. Kamei
近年来，确定性放化疗(DCRT)已成为食管鳞癌(ESCC)的基本治疗策略之一，尤其是在保留喉部的颈部ESCC中越来越普遍。我科最近推出了dCRT联合多西紫杉醇、顺铂和5-氟尿嘧啶(DCF-R)治疗晚期宫颈鳞癌。方法对2010年12月至2015年2月接受DCF-R一线治疗的11例晚期宫颈鳞癌(临床分期：II~IV期，包括T4b和/或M1淋巴结)患者进行回顾性研究。治疗前临床分期包括II期(1例)、III期(7例)、IV期(3例)，其中T4b期3例(气管2例，甲状腺1例)，M1期3例。完全缓解(CR)10例，稳定1例。10例CR患者中，5例复发，5例继续表现为CR。此外，3级或更多的不良反应包括白细胞减少(91%)、中性粒细胞减少(91%)、发热中性粒细胞减少(45%)和咽痛(55%)。两年总生存率为72%，两年无复发生存率为%。结论DCF-R治疗晚期颈段食道癌，只要慎用，虽有较强的血液毒性，但可在保留喉部的前提下获得良好的预后。
BackgroundRecently, definitive chemoradiotherapy (dCRT) has become one of the essential treatment strategies for esophageal squamous cell carcinoma (ESCC) and has been especially gaining prevalence for cervical ESCC to preserve the larynx. Our department recently introduced dCRT concomitant with docetaxel, cisplatin, and 5-fluorouracil (DCF-R) for treating advanced cervical ESCC. This study aims to assess the safety and outcomes of DCF-R in patients with advanced cervical ESCC.MethodsWe retrospectively assessed 11 patients with advanced cervical ESCC (clinical stage: II–IV, including T4b and/or M1 lymph node) who received DCF-R as the first-line treatment between December 2010 and February 2015.ResultsOur patient cohort comprised 8 males and 3 females (median age 68 years; range 54–76 years). The pretreatment clinical stage included stage II (1), stage III (7), and stage IV (3) cases [including 3 patients with T4b (2 trachea and 1 thyroid) and 3 patients with M1 lymph node]. We attained complete response (CR) in 10 patients and stable disease in 1 patient. Of 10 patients with CR, 5 experienced recurrence and 5 continued exhibiting CR. Furthermore, grade 3 or more adverse events included leucopenia (91%), neutropenia (91%), febrile neutropenia (45%), and pharyngeal pain (55%). While the 2-year overall survival rate was 72%, the 2-year recurrent-free survival rate was 64%, respectively.ConclusionsDCF-R treatment for advanced cervical esophageal cancer could be completed by the careful administration; although a strong blood toxicity might occur, this treatment may provide the chance to obtain favorable prognosis with larynx preservation.