The Pattern of Residual Tumor After Neoadjuvant Chemotherapy for Locally Advanced Esophageal Cancer and Its Clinical Significance

2020 ◽  
Vol 271 (5) ◽  
pp. 875-884 ◽  
Author(s):  
Tadayoshi Hashimoto ◽  
Tomoki Makino ◽  
Makoto Yamasaki ◽  
Koji Tanaka ◽  
Yasuhiro Miyazaki ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Clinical Significance ◽  
Locally Advanced ◽  
Residual Tumor ◽  
Advanced Esophageal Cancer ◽  
Locally Advanced Esophageal Cancer

PS02.109: CLINICAL SIGNIFICANCE OF NEOADJUVANT CHEMOTHERAPY IN ESOPHAGEAL CANCER PATIENTS WITH SEVERE DYSPHAGIA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 151-152
Author(s):  
Shin-Ichi Kosugi ◽  
Mariko Nemoto ◽  
Hiroshi Ichikawa ◽  
Yusuke Muneoka ◽  
Yosuke Kano ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Adverse Events ◽  
Clinical Significance ◽  
Curative Resection ◽  
Locally Advanced ◽  
Advanced Esophageal Cancer ◽  
Severe Dysphagia ◽  
Group A ◽  
Locally Advanced Esophageal Cancer

Abstract Background Neoadjuvant chemotherapy (NAC) followed by curative resection is a standard treatment for resectable locally advanced esophageal cancer. However, clinical significance of NAC for patients with severe dysphasia due to esophageal stenosis was not fully validated. Methods Fifty patients with resectable locally advanced esophageal cancer who received cisplatin and 5-fluorouracil followed by curative resection between 2006 and 2005 in our institution were retrospectively reviewed. Twenty-one patients required nutritional support due to severe dysphasia before or during NAC (Group A) and the remaining 29 patients had no dysphagia (Group B). Clinicopathological characteristics, nutritional status, treatment-related adverse events, and survival were compared between the two groups. Results Seventeen patients received enteral feeding with transnasal tube and the remaining 4 patients (19%) received parenteral nutrition alone in group A. There were no significant differences in tumor characteristics between the two groups. Serum albumin levels of group A and B before NAC were 3.8 and 4.3 g/dL (P = 0.02), and those after NAC were 3.6 and 4.0 g/dL, respectively (P < 0.01). NAC completion rates of group A and B were 86% and 83% (P = 0.78) and grade 3 or higher leukocytopenia developed in 33% and 10%, respectively (P = 0.07). Postoperative pneumonia of grade 2 or higher according to the Clavien-Dindo classification occurred in 48% and 28%, respectively (P = 0.23). Five-year overall survival rates of group A and B were 45% and 71%, respectively (P = 0.04). Conclusion NAC could be safely completed in patients with severe dysphagia; however, those were likely to have treatment-related adverse events and poorer survival. Disclosure All authors have declared no conflicts of interest.

Taxane based neoadjuvant chemotherapy in locally advanced esophageal cancer: A single centre experience

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15143-15143
Author(s):  
I. B. Ambulkar
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Locally Advanced ◽  
Advanced Esophageal Cancer ◽  
Improve Response Rate ◽  
Predominant Symptom ◽  
Single Centre Experience ◽  
Upper Gi Endoscopy ◽  
Grade Iii ◽  
Locally Advanced Esophageal Cancer

15143 Background: Neoadjuvant taxane based chemotherapy may improve response rate in patients with locally advanced esophageal cancer. We have evaluated paclitaxel based induction chemotherapy in patients with locally advanced esophageal cancer to determine its feasibility, clinical response, radiological and endoscopic response. Methods: etween November 2004 to October 2006, 30 patients were enrolled in this study. All patients were categorized as locally advanced esophageal cancer. They underwent CT scan chest and upper GI endoscopy before chemotherapy and 3 cycles after the chemotherapy. Chemotherapy included 3 cycles of paclitaxel (135 mg/m2 on day 1),5FU (500 mg/m2 on day 1,2,3) and cisplatin (25 mg/m2 on day 1,2,3) every 21 days. The main endpoint was response evaluation. Twenty one (70%) had squamous cell carcinoma and 9(30%) had adenocarcinoma. Median age was 44 years (39–75), 22(73.3%) were males and 8 were(26.6%) females. Dysphagia was the predominant symptom in 28 (93.3%) patients. Results: All 30 patients were evaluable for response and toxicity. Radiological and endoscopic CR was seen in 6(20%), PR in 16(53.3%),5(16.6%) had SD and 3(10%) had PD. Twenty five (83.3%) patients underwent radiotherapy to a total dose of 4500 cGY,5(16.6%) underwent surgery, 2(6.6%) showed complete pathological response. Observed toxicity was predominantly hematologic and leucopenia grade III/IV in 10% of cycles, Hb grade III/IV in 6.6% and thrombocytopenia grade III/IV in 3% of cycles.6.6% patients developed grade III/IV oral mucositis. Conclusions: Addition of paclitaxel to cisplatin and 5FU as neoadjuvant chemotherapy in esophageal cancer appears to be highly effective with complete as well as partial response rates. It can be given safely with manageable side effects. It is predicted that combination of paclitaxel, cisplatin and 5FU having excellent response as neoadjuvant therapy will also produce long term benefits. No significant financial relationships to disclose.

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