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Article: Docetaxel, Cisplatin, and 5-FU Triplet Therapy as Conversion Therapy for Locoregionally Advanced Unresectable Esophageal Squamous Cell Carcinoma

TitleDocetaxel, Cisplatin, and 5-FU Triplet Therapy as Conversion Therapy for Locoregionally Advanced Unresectable Esophageal Squamous Cell Carcinoma
Authors
Issue Date28-Oct-2022
PublisherSpringer
Citation
Annals of Surgical Oncology, 2023, v. 30, n. 2, p. 861-870 How to Cite?
Abstract

Background

The standard treatment for locoregionally advanced unresectable esophageal squamous cell carcinoma was radical chemoradiotherapy. However, the prognosis was modest. Emerging evidence showed the concept of induction chemotherapy with a goal of conversion surgery.

Methods

We reviewed the long-term, clinical outcomes and safety data of induction chemotherapy using docetaxel-cisplatin-5FU (DCF) and subsequent definitive treatment, either surgery or radical chemoradiotherapy (CRT), in locally advanced unresectable esophageal cancer in Queen Mary Hospital, Hong Kong. A total of 47 patients (median age 62 years, male: 41 (87.2%)) with locoregionally advanced unresectable esophageal cancer received induction DCF. The response rate was 65.9% (complete/partial response: n = 31). After induction DCF, 24 patients (41.4%) had radical surgery and 7 (14.9%) had definitive CRT.

Results

The median overall survival (mOS) was significantly longer in patients received subsequent surgery compared with those with definitive CRT (mOS: 40.2 vs. 9.1 months, hazard ratio 3.33, 95% confidence interval 1.22–9.07, p = 0.02) and no definitive treatment (mOS: 40.2 vs. 6.3 months, hazard ratio 8.51, 95% confidence interval 3.7–19.73, p < 0.001). Patients who received surgery, female, and those with supraclavicular lymph node involvement had a better OS. Twenty-one patients (44.7%) developed grade 3/4 adverse events during induction DCF, and two died after chemotherapy because of trachea–esophageal fistula complicated with sepsis. Eleven patients who had surgery had postoperative complications and none had postoperative mortality.

Conclusions

Induction DCF and subsequent conversion surgery offered a chance of cure with long-term survival benefit and manageable toxicities in patients with locoregionally advanced unresectable esophageal cancer.


Persistent Identifierhttp://hdl.handle.net/10722/331649
ISSN
2023 Impact Factor: 3.4
2023 SCImago Journal Rankings: 1.037
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChan, WL-
dc.contributor.authorChoi, CW-
dc.contributor.authorWong, IYH-
dc.contributor.authorTsang, THT-
dc.contributor.authorLam, ATC-
dc.contributor.authorTse, RPY-
dc.contributor.authorChan, KK-
dc.contributor.authorWong, C-
dc.contributor.authorLaw, BTT-
dc.contributor.authorCheung, EE-
dc.contributor.authorChan, SY-
dc.contributor.authorLam, KO-
dc.contributor.authorKwong, D-
dc.contributor.authorLaw, S-
dc.date.accessioned2023-09-21T06:57:40Z-
dc.date.available2023-09-21T06:57:40Z-
dc.date.issued2022-10-28-
dc.identifier.citationAnnals of Surgical Oncology, 2023, v. 30, n. 2, p. 861-870-
dc.identifier.issn1068-9265-
dc.identifier.urihttp://hdl.handle.net/10722/331649-
dc.description.abstract<h3>Background</h3><p>The standard treatment for locoregionally advanced unresectable esophageal squamous cell carcinoma was radical chemoradiotherapy. However, the prognosis was modest. Emerging evidence showed the concept of induction chemotherapy with a goal of conversion surgery.</p><h3>Methods</h3><p>We reviewed the long-term, clinical outcomes and safety data of induction chemotherapy using docetaxel-cisplatin-5FU (DCF) and subsequent definitive treatment, either surgery or radical chemoradiotherapy (CRT), in locally advanced unresectable esophageal cancer in Queen Mary Hospital, Hong Kong. A total of 47 patients (median age 62 years, male: 41 (87.2%)) with locoregionally advanced unresectable esophageal cancer received induction DCF. The response rate was 65.9% (complete/partial response: <em>n</em> = 31). After induction DCF, 24 patients (41.4%) had radical surgery and 7 (14.9%) had definitive CRT.</p><h3>Results</h3><p>The median overall survival (mOS) was significantly longer in patients received subsequent surgery compared with those with definitive CRT (mOS: 40.2 vs. 9.1 months, hazard ratio 3.33, 95% confidence interval 1.22–9.07, <em>p</em> = 0.02) and no definitive treatment (mOS: 40.2 vs. 6.3 months, hazard ratio 8.51, 95% confidence interval 3.7–19.73, <em>p</em> < 0.001). Patients who received surgery, female, and those with supraclavicular lymph node involvement had a better OS. Twenty-one patients (44.7%) developed grade 3/4 adverse events during induction DCF, and two died after chemotherapy because of trachea–esophageal fistula complicated with sepsis. Eleven patients who had surgery had postoperative complications and none had postoperative mortality.</p><h3>Conclusions</h3><p>Induction DCF and subsequent conversion surgery offered a chance of cure with long-term survival benefit and manageable toxicities in patients with locoregionally advanced unresectable esophageal cancer.</p>-
dc.languageeng-
dc.publisherSpringer-
dc.relation.ispartofAnnals of Surgical Oncology-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.titleDocetaxel, Cisplatin, and 5-FU Triplet Therapy as Conversion Therapy for Locoregionally Advanced Unresectable Esophageal Squamous Cell Carcinoma-
dc.typeArticle-
dc.identifier.doi10.1245/s10434-022-12694-8-
dc.identifier.scopuseid_2-s2.0-85141972449-
dc.identifier.volume30-
dc.identifier.issue2-
dc.identifier.spage861-
dc.identifier.epage870-
dc.identifier.eissn1534-4681-
dc.identifier.isiWOS:000875526600002-
dc.identifier.issnl1068-9265-

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