Induction chemotherapy with docetaxel/cisplatin/5-fluorouracil for patients with node-positive esophageal cancer

Masayuki Watanabe, Yohei Nagai, Kuichi Kinoshita, Seiya Saito, Junji Kurashige, Ryuichi Karashima, Kotaro Hirashima, Nobutaka Sato, Yu Imamura, Yukiharu Hiyoshi, Yoshifumi Baba, Shiro Iwagami, Yuji Miyamoto, Masaaki Iwatsuki, Naoko Hayashi, Hideo Baba

Research output: Contribution to journalArticle

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Abstract

Background: Despite improvements in the surgical management of esophageal cancer, the prognosis of patients with lymph node metastases is still unsatisfactory. Recently, survival benefit of neoadjuvant or induction chemotherapy for patients with esophageal cancer has been highlighted. Methods: Efficacy and toxicity of induction chemotherapy for esophageal cancer were reviewed. In addition, our experience on modified docetaxel/cisplatin/5-FU (DCF) as induction chemotherapy was also demonstrated. The modified DCF consisted of 60 mg/m2 of docetaxel on day 1, and 350 mg/m2 of 5-FU and 6 mg/m2 of cisplatin on days 1-5. Two courses have been administered as induction chemotherapy in 51 patients with node-positive esophageal cancer. Response was evaluated by RECIST v1.0 and changes in standardized uptake value by 18F-fluorodeoxyglucose positron emission tomography. Results: Induction chemotherapy may be beneficial for node-positive esophageal cancer, although the consensus has not yet been established. A regimen of induction chemotherapy should have a high response rate and cisplatin/5-FU may be underpowered as an induction setting. DCF can be a candidate for the regimen of induction chemotherapy for esophageal cancer, although severe adverse events have been reported. Several modified regimens to reduce the toxicity have been reported. The response rate of our series was 61% and a significant decrease in standardized uptake values was observed after the induction chemotherapy. Although high-grade neutropenia was still observed with this regimen, neither treatment-related death nor delay in the following treatment was observed. Conclusions: Modified DCF can be a regimen of induction chemotherapy for node-positive esophageal cancer because of its high efficacy, although an adequate care for severe neutropenia is needed.

Original languageEnglish
Pages (from-to)146-152
Number of pages7
JournalDigestion
Volume83
Issue number3
DOIs
Publication statusPublished - Jan 1 2011

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docetaxel
Induction Chemotherapy
Esophageal Neoplasms
Fluorouracil
Cisplatin
Neutropenia
Fluorodeoxyglucose F18

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Watanabe, M., Nagai, Y., Kinoshita, K., Saito, S., Kurashige, J., Karashima, R., ... Baba, H. (2011). Induction chemotherapy with docetaxel/cisplatin/5-fluorouracil for patients with node-positive esophageal cancer. Digestion, 83(3), 146-152. https://doi.org/10.1159/000321797

Induction chemotherapy with docetaxel/cisplatin/5-fluorouracil for patients with node-positive esophageal cancer. / Watanabe, Masayuki; Nagai, Yohei; Kinoshita, Kuichi; Saito, Seiya; Kurashige, Junji; Karashima, Ryuichi; Hirashima, Kotaro; Sato, Nobutaka; Imamura, Yu; Hiyoshi, Yukiharu; Baba, Yoshifumi; Iwagami, Shiro; Miyamoto, Yuji; Iwatsuki, Masaaki; Hayashi, Naoko; Baba, Hideo.

In: Digestion, Vol. 83, No. 3, 01.01.2011, p. 146-152.

Research output: Contribution to journalArticle

Watanabe, M, Nagai, Y, Kinoshita, K, Saito, S, Kurashige, J, Karashima, R, Hirashima, K, Sato, N, Imamura, Y, Hiyoshi, Y, Baba, Y, Iwagami, S, Miyamoto, Y, Iwatsuki, M, Hayashi, N & Baba, H 2011, 'Induction chemotherapy with docetaxel/cisplatin/5-fluorouracil for patients with node-positive esophageal cancer', Digestion, vol. 83, no. 3, pp. 146-152. https://doi.org/10.1159/000321797
Watanabe M, Nagai Y, Kinoshita K, Saito S, Kurashige J, Karashima R et al. Induction chemotherapy with docetaxel/cisplatin/5-fluorouracil for patients with node-positive esophageal cancer. Digestion. 2011 Jan 1;83(3):146-152. https://doi.org/10.1159/000321797
Watanabe, Masayuki ; Nagai, Yohei ; Kinoshita, Kuichi ; Saito, Seiya ; Kurashige, Junji ; Karashima, Ryuichi ; Hirashima, Kotaro ; Sato, Nobutaka ; Imamura, Yu ; Hiyoshi, Yukiharu ; Baba, Yoshifumi ; Iwagami, Shiro ; Miyamoto, Yuji ; Iwatsuki, Masaaki ; Hayashi, Naoko ; Baba, Hideo. / Induction chemotherapy with docetaxel/cisplatin/5-fluorouracil for patients with node-positive esophageal cancer. In: Digestion. 2011 ; Vol. 83, No. 3. pp. 146-152.
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T1 - Induction chemotherapy with docetaxel/cisplatin/5-fluorouracil for patients with node-positive esophageal cancer

AU - Watanabe, Masayuki

AU - Nagai, Yohei

AU - Kinoshita, Kuichi

AU - Saito, Seiya

AU - Kurashige, Junji

AU - Karashima, Ryuichi

AU - Hirashima, Kotaro

AU - Sato, Nobutaka

AU - Imamura, Yu

AU - Hiyoshi, Yukiharu

AU - Baba, Yoshifumi

AU - Iwagami, Shiro

AU - Miyamoto, Yuji

AU - Iwatsuki, Masaaki

AU - Hayashi, Naoko

AU - Baba, Hideo

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Background: Despite improvements in the surgical management of esophageal cancer, the prognosis of patients with lymph node metastases is still unsatisfactory. Recently, survival benefit of neoadjuvant or induction chemotherapy for patients with esophageal cancer has been highlighted. Methods: Efficacy and toxicity of induction chemotherapy for esophageal cancer were reviewed. In addition, our experience on modified docetaxel/cisplatin/5-FU (DCF) as induction chemotherapy was also demonstrated. The modified DCF consisted of 60 mg/m2 of docetaxel on day 1, and 350 mg/m2 of 5-FU and 6 mg/m2 of cisplatin on days 1-5. Two courses have been administered as induction chemotherapy in 51 patients with node-positive esophageal cancer. Response was evaluated by RECIST v1.0 and changes in standardized uptake value by 18F-fluorodeoxyglucose positron emission tomography. Results: Induction chemotherapy may be beneficial for node-positive esophageal cancer, although the consensus has not yet been established. A regimen of induction chemotherapy should have a high response rate and cisplatin/5-FU may be underpowered as an induction setting. DCF can be a candidate for the regimen of induction chemotherapy for esophageal cancer, although severe adverse events have been reported. Several modified regimens to reduce the toxicity have been reported. The response rate of our series was 61% and a significant decrease in standardized uptake values was observed after the induction chemotherapy. Although high-grade neutropenia was still observed with this regimen, neither treatment-related death nor delay in the following treatment was observed. Conclusions: Modified DCF can be a regimen of induction chemotherapy for node-positive esophageal cancer because of its high efficacy, although an adequate care for severe neutropenia is needed.

AB - Background: Despite improvements in the surgical management of esophageal cancer, the prognosis of patients with lymph node metastases is still unsatisfactory. Recently, survival benefit of neoadjuvant or induction chemotherapy for patients with esophageal cancer has been highlighted. Methods: Efficacy and toxicity of induction chemotherapy for esophageal cancer were reviewed. In addition, our experience on modified docetaxel/cisplatin/5-FU (DCF) as induction chemotherapy was also demonstrated. The modified DCF consisted of 60 mg/m2 of docetaxel on day 1, and 350 mg/m2 of 5-FU and 6 mg/m2 of cisplatin on days 1-5. Two courses have been administered as induction chemotherapy in 51 patients with node-positive esophageal cancer. Response was evaluated by RECIST v1.0 and changes in standardized uptake value by 18F-fluorodeoxyglucose positron emission tomography. Results: Induction chemotherapy may be beneficial for node-positive esophageal cancer, although the consensus has not yet been established. A regimen of induction chemotherapy should have a high response rate and cisplatin/5-FU may be underpowered as an induction setting. DCF can be a candidate for the regimen of induction chemotherapy for esophageal cancer, although severe adverse events have been reported. Several modified regimens to reduce the toxicity have been reported. The response rate of our series was 61% and a significant decrease in standardized uptake values was observed after the induction chemotherapy. Although high-grade neutropenia was still observed with this regimen, neither treatment-related death nor delay in the following treatment was observed. Conclusions: Modified DCF can be a regimen of induction chemotherapy for node-positive esophageal cancer because of its high efficacy, although an adequate care for severe neutropenia is needed.

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