15007 Background: Both oral fluoropyrimidine anti-cancer agent (UFT, S-1) and cisplatin can enhance the effectiveness of radiotherapy. We previously reported a phase II trial of UFT and cisplatin combined with radiotherapy (Int J Clin Oncol 8 (2003): 305–311) and a phase I trial of S-1 and cisplatin combined with radiotherapy (Jpn J Cancer Chemother 33 (2006): 224–229) for advanced esophageal cancer. The present study analyzes the efficacy of concurrent chemoradiotherapy by using S-1 and cisplatin for locally advanced esophageal cancer. Methods: Chemoradiotherapy consisted of two courses. The first course included 30 Gy of radiotherapy given over 3 weeks, together with daily oral administration of S-1 (80 mg/m2/day) for 2 weeks and a 24-h infusion of cisplatin (70 mg/m2) on day 8. The second course of chemoradiotherapy was administered after 2 weeks. For patients who exhibited an objective response to chemoradiotherapy, at least 2 four-week courses consisting of chemotherapy of S-1 and cisplatinon were administered. If a patient was unable to take S-1 as a capsule, S-1 was administered in the powdered form with water. Results: Fifty-nine patients were enrolled. They had the following characteristics: median age 65 years; M/F 52/7; PS 0/1/2: 33/19/7. There were 9 patients with stage II tumors and 50 with stage III. Fifty-four patients (92%) completed 2 courses of chemoradiotherapy. The major toxicity was myelosuppression. Fifteen patients (25%) developed grade 3 leukocytopenia, while 7 patients (12%) developed grade 4 leukocytopenia. Nonhematologic toxicity was moderate: grade 2 nausea/vomiting, pain, oral mucositis, and renal dysfunction occurred in 20%, 12%, 5% and 5% of patients, respectively. In stage II cases, complete response (CR), partial response (PR), and response rates were 78%, 22%, and 100%, respectively. In stage III cases, CR, PR, and response rates were 58%, 32%, and 90%, respectively. All stage II patients survived. In stage III cases, the 1-year survival rate was 70% and the 3-year survival rate was 44%. Conclusions: Chemoradiotherapy with S-1 and cisplatin is convenient, tolerable, and effective, and may be a promising nonsurgical management option for patients with locally advanced esophageal cancer. No significant financial relationships to disclose.
Toxicity, Response Rates and Survival Outcomes of Induction Cisplatin and Irinotecan Followed by Concurrent Cisplatin, Irinotecan and Radiotherapy for Locally Advanced Esophageal Cancer
