Induction chemoradiotherapy including docetaxel, cisplatin, and 5-fluorouracil for locally advanced esophageal cancer
Induction chemoradiotherapy including docetaxel, cisplatin, and 5-fluorouracil for locally advanced esophageal cancer
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DOI：
10.1007/s10388-019-00709-5
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发表时间：
2020-01-02
期刊：
影响因子：
2.4
通讯作者：
Fujiwara, Toshiyoshi
中科院分区：
文献类型：
--
作者：
Hashimoto, Masashi;Shirakawa, Yasuhiro;Fujiwara, Toshiyoshi
背景局部晚期食管癌（EC）侵犯周围器官（T4 b）是一种较难治疗的疾病，一般采用确定性放化疗（d-CRT）治疗。然而，结果并不好。最近，已报道了多西他赛、顺铂和5-氟尿嘧啶（DCF-RT）联合d-CRT的有效性。此外，在一些报告中，d-CRT后的手术比单独d-CRT具有更好的预后，尽管其具有较高的手术并发症风险。方法以2011年1月至2017年12月在冈山大学附属医院接受诱导性DCF-RT的EC患者为研究对象。对他们的背景特征、治疗细节、组织病理学因素、CRT期间的不良事件、术后并发症和总生存期（OS）进行了评估。结果16例患者均行诱导DCF-RT，死亡10例，其中9例死于肿瘤，1例死于其他疾病。所有病例的3年OS为37.5%。12例患者在DCF-RT后行食管切除术，3年OS为50%。13例患者（81.3%）发生3级发热性中性粒细胞减少症。7例（62.5%）需要禁食治疗腹泻。3例患者（25%）发生吻合口瘘。喉返神经部分麻痹6例（50%）。结论虽然不良事件发生率和手术并发症发生率略高于以往报道，但可以接受。对T4 b EC进行诱导DCF-RT是有用的。
Background Locally advanced esophageal cancer (EC) invading surrounding organs (T4b) is difficult to treat. In general, definitive chemoradiotherapy (d-CRT) has been chosen as treatment for such cases. However, the outcome has not been good. Recently, the effectiveness of d-CRT with docetaxel, cisplatin, and 5-fluorouracil (DCF-RT) has been reported. Furthermore, surgery after d-CRT has a better prognosis than d-CRT alone in some reports, although it has a high risk of surgical complications. This study investigated the effectiveness and safety of induction DCF-RT. Methods The subjects were EC patients who underwent induction DCF-RT in Okayama University Hospital between January 2011 and December 2017. Their background characteristics, treatment details, histopathological factors, adverse events during CRT, postoperative complications, and overall survival (OS) were assessed. Results A total of 16 cases were performed induction DCF-RT. In 10 cases, death occurred, with 9 cancer-related deaths, and 1 death due to other disease. For all cases, OS was 37.5% at 3 years. 12 cases underwent esophagectomy after DCF-RT. Their OS was 50% at 3 years. 13 patients (81.3%) had Grade 3 febrile neutropenia. In 7 cases (62.5%), fasting for the treatment of diarrhea was needed. Three patients (25%) developed anastomotic leakage. Some recurrent laryngeal nerve paralysis was observed in 6 cases (50%). Conclusion Although the rates of adverse events and surgical complications were slightly higher than in past reports, they were acceptable. It is useful to perform induction DCF-RT for T4b EC.