Planned Esophagectomy after Neoadjuvant Hyperthermo-Chemoradiotherapy using Weekly Low-Dose Docetaxel and Hyperthermia for Advanced Esophageal Carcinomas.

Abstract

BACKGROUND/AIMS:

The optimal treatment for locally advanced esophageal carcinoma has not yet been determined. We report results of neoadjuvant hyperthermo-chemoradiotherapy (HCRT) using weekly low-dose docetaxel followed by surgery in patients with advanced esophageal squamous cell carcinoma.

METHODOLOGY:

Twenty-four patients were enrolled. 7 patients were considered to have inoperable tumors or rejected surgery after HCRT, and the remaining 17 patients had an esophagectomy. Clinical responses, HCRT toxicity and survival after surgery were evaluated.

RESULTS:

In the 24 patients, the response rate was 41.7%. The pathological complete response (pCR) rate was 17.6% in the 17 patients. HCRT toxicity grade 2 occurred in six patients (25.0%: esophagitis, 4; leukopenia, 6; neutropenia, 4) and grade 3 (pneumonia) in 3 patients (12.5%). The 3- and 5-year survival rates were 56.3% and 50.0%, respectively. When the patients were divided into a pCR group and a pathological partial response (pPR) group, the 3-year survival rates were 66.7% and 42.9% and the 5-year survival rates were 66.7% and 42.9%, respectively (log-rank P = .5842).

CONCLUSIONS:

Esophagectomy after docetaxel HCRT may have potential for prolonging survival in patients with locally advanced esophageal cancer. A larger randomized, controlled study will be required to confirm the benefit of esophagectomy after HCRT.

• Authors: Masanobu Nakajima, Hiroyuki Kato, Makoto Sakai, Akihiko Sano, Tatsuya Miyazaki, Makoto Sohda, Takanori Inose, Naritaka Tanaka, Shigemasa Suzuki, Norihiro Masuda, Minoru Fukuchi, Hiroyuki Kuwano
• Journal: Hepato-gastroenterology (Hepatogastroenterology) Vol. 62 Issue 140 Pg. 887-91 (Jun 2015) ISSN: 0172-6390 [Print] Greece
• PMID: 26902022 (Publication Type: Clinical Study, Journal Article)

Chemical References

• Antineoplastic Agents
• Taxoids
• Docetaxel

Topics

• Aged
• Antineoplastic Agents (administration & dosage)
• Carcinoma, Squamous Cell (therapy)
• Chemoradiotherapy (adverse effects, methods)
• Cohort Studies
• Docetaxel
• Esophageal Neoplasms (therapy)
• Esophageal Squamous Cell Carcinoma
• Esophagectomy
• Esophagitis (etiology)
• Female
• Humans
• Hyperthermia, Induced (adverse effects, methods)
• Leukopenia (etiology)
• Male
• Middle Aged
• Neoadjuvant Therapy (adverse effects, methods)
• Neutropenia (etiology)
• Prospective Studies
• Survival Rate
• Taxoids (administration & dosage)
• Treatment Outcome