Advertisement

Esophagus

, Volume 15, Issue 4, pp 281–285 | Cite as

Definitive chemoradiotherapy with docetaxel, cisplatin, and 5-fluorouracil (DCF-R) for advanced cervical esophageal cancer

  • Hiroshi OkamotoEmail author
  • Yusuke Taniyama
  • Tadashi Sakurai
  • Takahiro Heishi
  • Jin Teshima
  • Chiaki Sato
  • Shota Maruyama
  • Ken Ito
  • Yu Onodera
  • Takuro Konno-Kumagai
  • Hirotaka Ishida
  • Takashi Kamei
Original Article

Abstract

Background

Recently, 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.

Methods

We 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.

Results

Our 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.

Conclusions

DCF-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.

Keywords

Esophageal squamous cell carcinoma Chemoradiotherapy Docetaxel Cisplatin 5-Fluorouracil 

Notes

Acknowledgements

The authors thank Enago (http://www.enago.jp) for the English language review.

Compliance with ethical standards

Ethical statement

This study was approved by the ethical committee of our institute (accession number: 2017-4-064), and we obtained informed consent from all patients before enrollment. We conducted this study in accordance with the Declaration of Helsinki (1975).

Conflict of interest

The authors have no conflicts of interest or financial ties to disclose.

References

  1. 1.
    Kato K, Muro K, Minashi K, et al. Phase II study of chemoradiotherapy with 5-fluorouracil and cisplatin for Stage II–III esophageal squamous cell carcinoma: JCOG trial (JCOG 9906). Int J Radiat Oncol Biol Phys. 2011;81:684–90.CrossRefPubMedGoogle Scholar
  2. 2.
    Ariga H, Nemoto K, Miyazaki S, et al. Prospective comparison of surgery alone and chemoradiotherapy with selective surgery in resectable squamous cell carcinoma of the esophagus. Int J Radiat Oncol Biol Phys. 2009;75:348–56.CrossRefPubMedGoogle Scholar
  3. 3.
    Higuchi K, Komori S, Tanabe S, et al. Definitive chemoradiation therapy with docetaxel, cisplatin, and 5-fluorouracil (DCF-R) in advanced esophageal cancer: a phase 2 trial (KDOG 0501-P2). Int J Radiat Oncol Biol Phys. 2014;89:872–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Burmeister BH, Dickie G, Smithers BM, et al. Thirty-four patients with carcinoma of the cervical esophagus treated with chemoradiation therapy. Arch Otolaryngol Head Neck Surg. 2000;126:205–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Cao C, Luo J, Gao L, et al. Definitive radiotherapy for cervical esophageal cancer. Head Neck. 2015;37:151–5.CrossRefPubMedGoogle Scholar
  6. 6.
    Gkika E, Gauler T, Eberhardt W, et al. Long-term results of definitive radiochemotherapy in locally advanced cancers of the cervical esophagus. Dis Esophagus. 2014;27:678–84.CrossRefPubMedGoogle Scholar
  7. 7.
    Kumabe A, Zenda S, Motegi A, et al. Long-term clinical results of concurrent chemoradiotherapy for patients with cervical esophageal squamous cell carcinoma. Anticancer Res. 2017;37:5039–44.PubMedGoogle Scholar
  8. 8.
    Li HX, Liu J, Cheng Y, et al. Concurrent chemoradiotherapy for cervical esophageal squamous cell carcinoma: treatment results from a prospective observational study. Dis Esophagus. 2018.  https://doi.org/10.1093/dote/dox144 CrossRefPubMedGoogle Scholar
  9. 9.
    Uno T, Isobe K, Kawakami H, et al. Concurrent chemoradiation for patients with squamous cell carcinoma of the cervical esophagus. Dis Esophagus. 2007;20:12–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Yamada K, Murakami M, Okamoto Y, et al. Treatment results of radiotherapy for carcinoma of the cervical esophagus. Acta Oncol. 2006;45:1120–5.CrossRefPubMedGoogle Scholar
  11. 11.
    Zenda S, Kojima T, Kato K, et al. Multicenter phase 2 study of cisplatin and 5-fluorouracil with concurrent radiation therapy as an organ preservation approach in patients with squamous cell carcinoma of the cervical esophagus. Int J Radiat Oncol Biol Phys. 2016;96:976–84.CrossRefPubMedGoogle Scholar
  12. 12.
    Zhang P, Xi M, Zhao L, et al. Clinical efficacy and failure pattern in patients with cervical esophageal cancer treated with definitive chemoradiotherapy. Radiother Oncol. 2015;116:257–61.CrossRefPubMedGoogle Scholar
  13. 13.
    Ito M, Kodaira T, Tachibana H, et al. Clinical results of definitive chemoradiotherapy for cervical esophageal cancer: Comparison of failure pattern and toxicities between intensity-modulated radiotherapy and 3-dimensional conformal radiotherapy. Head Neck. 2017;39:2406–15.CrossRefPubMedGoogle Scholar
  14. 14.
    Daiko H, Hayashi R, Saikawa M, et al. Surgical management of carcinoma of the cervical esophagus. J Surg Oncol. 2007;96:166–72.CrossRefPubMedGoogle Scholar
  15. 15.
    Jiang M, He X, Wu D, et al. Reconstruction techniques for hypopharyngeal and cervical esophageal carcinoma. J Thorac Dis. 2015;7:449–54.PubMedCentralPubMedGoogle Scholar
  16. 16.
    Nishimaki T, Kanda T, Nakagawa S, et al. Outcomes and prognostic factors after surgical resection of hypopharyngeal and cervical esophageal carcinomas. Int Surg. 2002;87:38–44.PubMedGoogle Scholar
  17. 17.
    Triboulet JP, Mariette C, Chevalier D, et al. Surgical management of carcinoma of the hypopharynx and cervical esophagus: analysis of 209 cases. Arch Surg. 2001;136:1164–70.CrossRefPubMedGoogle Scholar
  18. 18.
    Wang HW, Chu PY, Kuo KT, et al. A reappraisal of surgical management for squamous cell carcinoma in the pharyngoesophageal junction. J Surg Oncol. 2006;93:468–76.CrossRefPubMedGoogle Scholar
  19. 19.
    Miyazaki T, Sohda M, Tanaka N, et al. Phase I/II study of docetaxel, cisplatin, and 5-fluorouracil combination chemoradiotherapy in patients with advanced esophageal cancer. Cancer Chemother Pharmacol. 2015;75:449–55.CrossRefPubMedGoogle Scholar
  20. 20.
    Fujishima F, Taniyama Y, Nakamura Y, et al. Residual carcinoma cells after chemoradiotherapy for esophageal squamous cell carcinoma patients: striving toward appropriate judgment of biopsy. Dis Esophagus. 2018;Epub ahead of print.Google Scholar
  21. 21.
    Cao CN, Luo JW, Gao L, et al. Intensity-modulated radiotherapy for cervical esophageal squamous cell carcinoma: clinical outcomes and patterns of failure. Eur Arch Otorhinolaryngol. 2016;273:741–7.CrossRefPubMedGoogle Scholar
  22. 22.
    Yang H, Feng C, Cai BN, et al. Comparison of three-dimensional conformal radiation therapy, intensity-modulated radiation therapy, and volumetric-modulated arc therapy in the treatment of cervical esophageal carcinoma. Dis Esophagus. 2017;30:1–8.PubMedGoogle Scholar
  23. 23.
    Zhao L, Zhou Y, Mu Y, et al. Patterns of failure and clinical outcomes of definitive radiotherapy for cervical esophageal cancer. Oncotarget. 2017;8:21852–60.PubMedCentralPubMedGoogle Scholar
  24. 24.
    Fenkell L, Kaminsky I, Breen S, et al. Dosimetric comparison of IMRT vs. 3D conformal radiotherapy in the treatment of cancer of the cervical esophagus. Radiother Oncol. 2008;89:287–91.CrossRefPubMedGoogle Scholar

Copyright information

© The Japan Esophageal Society and Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  • Hiroshi Okamoto
    • 1
    • 2
    Email author
  • Yusuke Taniyama
    • 1
  • Tadashi Sakurai
    • 1
  • Takahiro Heishi
    • 1
  • Jin Teshima
    • 1
    • 3
  • Chiaki Sato
    • 1
  • Shota Maruyama
    • 1
  • Ken Ito
    • 1
  • Yu Onodera
    • 1
  • Takuro Konno-Kumagai
    • 1
  • Hirotaka Ishida
    • 1
  • Takashi Kamei
    • 1
  1. 1.Department of Gastroenterological Surgery, Graduate School of MedicineTohoku UniversitySendaiJapan
  2. 2.Department of Community Medical Supports, Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
  3. 3.Department of SurgeryIwate Prefectural Central HospitalMoriokaJapan

Personalised recommendations