Prospective study of definitive chemoradiotherapy with S-1 and nedaplatin in patients with stage II/III (non-T4) esophageal cancer
Prospective study of definitive chemoradiotherapy with S-1 and nedaplatin in patients with stage II/III (non-T4) esophageal cancer
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DOI：
10.1007/s10388-011-0261-0
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发表时间：
2011-03-01
期刊：
影响因子：
2.4
通讯作者：
Itoh, Fumio
中科院分区：
文献类型：
--
作者：
Tsuda, Takashi;Inaba, Hiroyuki;Itoh, Fumio
背景：使用5-FU和CDDP的标准化放疗（CRT）是II/III期（非T4）食管癌患者的最佳治疗方法。然而，患者的生活质量（QOL）不一定能保持在这种治疗过程中，因为5-FU必须连续输注24小时和CDDP管理需要大量的输血量。因此，住院治疗是不可避免的。我们进行了一项研究，确定CRT与S-1和nedaplatin.Methods该研究是在2004年7月和2006年12月之间进行的。入选标准为II/III期（非T4），PS 0-2，年龄20-79岁，器官功能良好。替吉奥80 mg/m2，第1-14天;奈达铂90 mg/m2，第1天，每4周1次。结果20例患者（年龄范围50-75岁; PS 0/1，8/12;阶段IIA/IIB/III，11/2/7）被招募。4级白细胞减少、血小板减少和贫血分别发生在15%、10%和5%的患者中。3级非血液毒性包括3例患者（15%）的食管炎和2例患者（10%）的厌食症。1例患者发生发热性中性粒细胞减少症;另1例发生食管瘘。完全缓解率为80%。3年总生存率为58.0%。结论替吉奥和奈达铂联合放疗是可行的，毒副反应可以耐受。这种治疗方法有可能缩短住院时间，维持患者的生活质量，而不损害CRT的疗效。
Background Standard chemoradiotherapy (CRT) using 5-FU and CDDP is the optimal treatment for patients with stage II/III (non-T4) esophageal carcinoma. However, patient quality of life (QOL) cannot necessarily be maintained during this therapy, because 5-FU must be continuously infused for 24 h and CDDP administration requires a large transfusion volume. Therefore, hospitalization is unavoidable. We conducted a study of definitive CRT with S-1 and nedaplatin.Methods The study was conducted between July 2004 and December 2006. Eligibility criteria were stage II/III (non-T4), PS 0-2, age 20-79 years, and adequate organ function. S-1 80 mg/m(2) was given on days 1-14, and nedaplatin 90 mg/m(2) on day 1 every 4 weeks. Patients received two courses with concurrent radiotherapy of more than 50 Gy.Results Twenty patients (age range, 50-75 years; PS 0/1, 8/12; stage IIA/IIB/III, 11/2/7) were enrolled. Grade 4 leukopenia, thrombocytopenia, and anemia occurred in 15%, 10%, and 5% of patients, respectively. Grade 3 nonhemato-toxicity included esophagitis in 3 patients (15%) and anorexia in 2 (10%). One patient developed febrile neutropenia; another developed an esophageal fistula. Complete response was achieved in 80%. The 3-year overall survival rate was 58.0%. Thirteen subjects received treatment as outpatients.Conclusions S-1 and nedaplatin in combination with radiotherapy is feasible, and toxicity is tolerable. This treatment method has the potential to shorten hospitalization and maintain patient QOL without impairing the efficacy of CRT.