scholarly journals Clinico-epidemiological profile and treatment outcomes in patients with squamous cell carcinoma of the esophagus following docetaxel-based neoadjuvant chemotherapy: experience from a cancer care center in Northeast India

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Partha Sarathi Roy ◽  
Gaurav Kumar ◽  
Sreya Mallik ◽  
Satya Sadhan Sarangi ◽  
Bhargab Jyoti Saikia ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Response Rates ◽  
Drug Regimen ◽  
Pathological Response ◽  
Complete Pathological Response ◽  
Carcinoma Of The Esophagus ◽  
Grade 3

Abstract Background Squamous cell carcinoma of the esophagus ranks as the most common cause of cancer incidence and mortality in males and the second most common in females. Surgery alone is associated with poor long-term survival. Neoadjuvant chemoradiation and perioperative chemotherapy without radiation have been tried to improve survival rates. Methods We retrospectively evaluated the neoadjuvant chemotherapy in forty-eight patients with non-metastatic, non-cervical squamous cell carcinoma of the esophagus with a docetaxel-based three-drug regimen to improve complete pathological response rates. Results The median age of presentation was 52 years, with male preponderance. All the patients received three cycles of docetaxel-cisplatin-fluorouracil-based chemotherapy. A complete pathological response to neoadjuvant chemotherapy was seen in 8 patients (17%). Rates of grade 3 hematological toxicities were seen in 12% of patients, with no observed grade 4 toxicity. The most common non-hematological toxicity was grade 3 alopecia (seen in 40%) and grade 2 nausea/vomiting in 8% of patients. At a median follow-up of 26.5 months, 2-year survival for the patients receiving chemotherapy and surgery is 66%. Conclusions Preoperative chemotherapy with a taxane-based triple-drug regimen is a reasonable approach in squamous cell carcinoma of the esophagus, associated with improvement in complete pathological response rates, increases complete resection rates, with manageable toxicity.

Neoadjuvant chemotherapy plus concurrent chemotherapy and high-dose radiation for squamous cell carcinoma of the esophagus: a preliminary analysis of the phase II intergroup trial 0122.

1996 ◽  
Vol 14 (1) ◽  
pp. 149-155 ◽  
Author(s):  
B D Minsky ◽  
D Neuberg ◽  
D P Kelsen ◽  
T M Pisansky ◽  
R Ginsberg ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Radiation Therapy ◽  
Neoadjuvant Chemotherapy ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Concurrent Chemotherapy ◽  
High Dose ◽  
Carcinoma Of The Esophagus ◽  
Combined Modality ◽  
Grade 3

PURPOSE To determine the preliminary acute toxicity and survival results of neoadjuvant chemotherapy followed by concurrent chemotherapy plus high-dose radiation therapy in patients with local/regional squamous cell carcinoma of the esophagus. MATERIALS AND METHODS Forty-five patients with clinical stage T1-4N0-1M0 squamous cell carcinoma were entered onto the trial. Eight patients were declared ineligible after registration. Patients received three monthly cycles of fluorouracil (5-FU; 1,000 mg/m2/24hr for 5 days) and cisplatin (100 mg/m2 on day 1) (neoadjuvant segment) followed by two additional monthly cycles of 5-FU (1,000 mg/m2/24hr for 5 days) and cisplatin (75 mg/m2 on day 1) plus concurrent 64.8 Gy (combined modality segment). RESULTS With a median follow-up of 15 months in surviving patients, the incidence of total grade 3+ toxicity during the neoadjuvant chemotherapy segment was 61%, and during the combined modality segment was 72%. Of the 33 patients who started radiation therapy, 91% were able to complete the full course. There were six deaths during treatment, five of which (11%), because of nadir sepsis and/or dehydration, were treatment-related. For the 37 eligible patients, the median disease-free survival duration was 9 months, and the overall median survival was 20 months. CONCLUSION The preliminary analysis of this trial demonstrated that the incidence of grade 3+ toxicity was similar to that reported in the combined modality arm of the prior Radiation Therapy Oncology Group (RTOG) intergroup esophageal trial RTOG 85-01. However, because of the increased incidence of treatment-related mortality, this treatment program will not be used as an experimental arm of intergroup trial INT 0123 (RTOG 94-05).

PS02.086: ENDOSCOPIC RESPONSE EVALUATION OF NEOADJUVANT CHEMOTHERAPY CAN PREDICT PATHOLOGICAL RESPONSE AND SURVIVAL IN PATIENTS WITH ESOPHAGEAL SQUAMOUS CELL CARCINOMA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 145-145
Author(s):  
Yohei Nagai ◽  
Naoya Yoshida ◽  
Yoshifumi Baba ◽  
Hideo Baba
Keyword(s):  
Squamous Cell Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Clinical Response ◽  
Squamous Cell ◽  
Conflicts Of Interest ◽  
Pathological Response ◽  
Response Evaluation ◽  
Radical Esophagectomy

Abstract Background To investigate the association between endoscopic response evaluation of neoadjuvant chemotherapy (NAC) with pathological response and survival in patients with esophageal squamous cell carcinoma (ESCC). Methods We retrospectively reviewed the medical records of patients with the aid of a prospectively entered database. One hundred and eleven consecutive patients with ESCC who underwent radical esophagectomy after NAC were included. All patients were divided into two groups according to endoscopic response after NAC: endoscopic non-responders in whom NAC was poorly or moderately effective, and endoscopic responders in whom NAC was highly effective or completely effective. The clinical response after NAC was evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST). Results The pretreatment clinical stage was IB in 5 patients (5%), II in 18 (16%), III in 72 (65%), and IV in 16 (14%). All patients received two courses of chemotherapy. Chemotherapy consisted of docetaxel, cisplatin (CDDP), and 5-fluorouracil (5-FU; the DCF regimen) in 82 patients (74%), and 5-FU and CDDP (FP) in 29 (26%). All patients underwent radical esophagectomy with 2- or 3-field lymph node dissection. The postoperative mortality and morbidity rates were 0.9% and 26%, respectively. Pathological stage (ypStage) was 0 in 1 patient (1%), I in 16 (14%), II in 31 (28%), III in 48 (43%), and IV in 15 (13%). Twenty-two patients (20%) were pathological responders, and this group of patients had better overall survival than pathological non-responders (P = 0.02). Pathological response was significantly correlated with tumor depth (cT) (P < 0.01), protruding type of tumor (P = 0.01) before NAC, and clinical response (P < 0.01) and endoscopic response (P < 0.01) after NAC. Of these clinical factors, clinical response and endoscopic response were significantly correlated with prognosis. Conclusion Endoscopic response after NAC can predict the pathological response and prognosis of patients who received NAC followed by surgery. Endoscopic findings are clinically significant to assess the response of NAC in patients with ESCC. Disclosure All authors have declared no conflicts of interest.

A phase I/II study of divided-dose docetaxel, cisplatin, and fluorouracil (DCF) for patients with recurrent or metastatic squamous cell carcinoma of the esophagus.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 132-132
Author(s):  
Toshiyasu Ojima ◽  
Mikihito Nakamori ◽  
Masaki Nakamura ◽  
Makoto Iwahashi ◽  
Masahiro Katsuda ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Phase I ◽  
Cell Carcinoma ◽  
Phase Ii ◽  
Squamous Cell ◽  
Response Rate ◽  
Carcinoma Of The Esophagus ◽  
Metastatic Squamous Cell Carcinoma ◽  
Level 3 ◽  
Grade 3

132 Background: The aim of this phase I/II study was to evaluate the efficacy and safety of the combined use of docetaxel, cisplatin (CDDP) and 5-fluorouracil (5-FU) (DCF) in patients with recurrent/metastatic squamous cell carcinoma of the esophagus (SCCE). This study adopted divided doses of docetaxel and CDDP in order to reduce the toxicities of the treatment. Methods: The dose of docetaxel was escalated using the following protocol in the phase I stage: level 1, 30; level 2, 35 and level 3, 40 mg/m2, which was intravenously infused for two hours on days 1 and 8. CDDP was administered at a dose of 12 mg/m2 infused for four hours on days 1-5. The 5-FU was administered at a dose of 600 mg/m2continuously infused from day 1 to 5. This regimen was repeated every four weeks. Results: The study subjects were nine patients (phase I) and 48 patients (phase II). The recommended dose was determined as level 3 in phase I. In the phase II stage, the overall response rate was 62.5%, with a complete response rate of 12.5%. The median progression-free survival was six months, and the median overall survival was 13 months. Grade 3/4 toxicities of leukopenia, neutropenia and febrile neutropenia occurred in 64.6, 68.8 and 14.6% of the patients, while grade 3/4 non-hematological toxicities were relatively rare. No treatment-related death was recorded. Conclusions: This modified DCF regimen can be a tolerable definitive chemotherapy for unresectable SCCE because of its high efficacy, although adequate care for severe neutropenia is needed. Clinical trial information: NCT00915850.

Definitive Chemoradiotherapy for T4 and/or M1 Lymph Node Squamous Cell Carcinoma of the Esophagus

1999 ◽  
Vol 17 (9) ◽  
pp. 2915-2915 ◽  
Author(s):  
Atsushi Ohtsu ◽  
Narikazu Boku ◽  
Kei Muro ◽  
Keisho Chin ◽  
Manabu Muto ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Locally Advanced ◽  
Dose Intensity ◽  
Complete Response ◽  
Carcinoma Of The Esophagus ◽  
Advanced Carcinoma ◽  
Grade 3

PURPOSE: To investigate the efficacy and feasibility of concurrent chemoradiotherapy for locally advanced carcinoma of the esophagus. PATIENTS AND METHODS: Fifty-four patients with clinically T4 and/or M1 lymph node (LYM) squamous cell carcinoma of the esophagus were enrolled. Patients received protracted infusion of fluorouracil 400 mg/m2/24 hours on days 1 to 5 and 8 to 12, 2-hour infusion of cisplatin 40 mg/m2 on days 1 and 8, and concurrent radiation therapy at a dose of 30 Gy in 15 fractions over 3 weeks. Filgrastim was prophylactically administered to 35 patients. This schedule was repeated twice every 5 weeks, for a total radiation dose of 60 Gy, followed by two courses of fluorouracil (800 mg/m2/24 hours for 5 days) and cisplatin (80 mg/m2 on day 1). RESULTS: There were 21 patients with T4M0 disease, one with T2M1 LYM, 17 with T3M1 LYM, and 15 withT4M1 LYM. Forty-nine patients (91%) completed at least the chemoradiotherapy segment. The 18 patients (33%) who achieved a complete response included nine (25%) of the 36 with T4 disease and nine (50%) of the 18 with non-T4 disease. Major toxicities were leukocytopenia and esophagitis; there were four (7%) treatment-related deaths. Prophylactic filgrastim reduced the incidence of grade 3 or worse leukopenia without improving dose-intensity or response. With a median follow-up duration of 43 months, median survival time was 9 months. The 3-year survival rate was 23%. CONCLUSION: Despite its significant toxicity, this combined modality seemed to have curative potential even in cases of locally advanced carcinoma of the esophagus.

Expression of ERCC1, TUBB3, BRCA1, and TS as predictive markers of neoadjuvant chemotherapy for squamous cell carcinoma of the esophagus.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 47-47 ◽  
Author(s):  
Toshiyasu Ojima ◽  
Mikihito Nakamori ◽  
Masaki Nakamura ◽  
Masahiro Katsuda ◽  
Keiji Hayata ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Prognostic Factors ◽  
Neoadjuvant Chemotherapy ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Brca1 Expression ◽  
Carcinoma Of The Esophagus ◽  
Chemotherapeutic Efficacy ◽  
Ercc1 Expression

47 Background: No predictive biomarker of the response to neoadjuvant chemotherapy with docetaxel and cisplatin plus 5-fluorouracil (NAC-DCF) is available for patients with squamous cell carcinoma of the esophagus (SCCE) in a clinical setting. The aim of this study was to identify the biomarkers associated with chemotherapeutic efficacy and long-term survival for patients with advanced SCCE who had received NAC-DCF followed by surgery. Methods: This study included 45 patients with advanced SCCE who received NAC-DCF between January 2008 and December 2012. The NAC-DCF was conducted as a phase II study (UMIN000007408). The expressions of excision repair cross-complementing-1 (ERCC1), class III beta-tubulin, breast cancer susceptibility gene I (BRCA1), and thymidylate synthase were investigated simultaneously in the pre-treatment endoscopic tumor biopsy samples. Results: The multivariate logistic regression analysis indicated that pathological responses were significantly associated with tumors with low ERCC1 expression (P = 0.016) and with tumors with high BRCA1 expression (P = 0.014). The incidence of pathological responses to DCF in patients with low ERCC1 and high BRCA1 expressions was 100%. The multivariate Cox proportional hazard model analysis for relapse-free survival (RFS) revealed tumors with high BRCA1 expression (P = 0.031, hazards ratio, 4.39) as independent prognostic factors. Conclusions: Low ERCC1 expression and high BRCA1 expression in patients with SCCE were predictive biomarkers for chemotherapeutic efficacy. High BRCA1 expression was considered as prognostic factors for long-term RFS. These results may be a helpful tool for tailoring chemotherapy of patients with SCCE. Prospective validation of this biomarker panel is warranted. Clinical trial information: UMIN000007408.

Volume reduction rate of the primary tumor as an objective clinical measure to evaluate efficacy of neoadjuvant chemotherapy for esophageal squamous cell carcinoma.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 42-42
Author(s):  
Shinsuke Nagasawa ◽  
Takashi Ogata ◽  
Kentaro Hara ◽  
Hiroaki Osakabe ◽  
Masato Nakazono ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Primary Tumor ◽  
Tumor Volume ◽  
Reduction Rate ◽  
Volume Reduction ◽  
Grade 3

42 Background: Neoadjuvant chemotherapy (NAC) followed by surgery is a standard treatment for esophageal squamous cell carcinoma (ESCC) in Japan. Efficacy of NAC on the primary tumor is clinically evaluated during NAC and before surgery and is pathologically examined after surgery. Clinical evaluation of the primary tumor is sometimes difficult because primary tumor is nonmesurable lesion and is usually evaluated subjectively, while pathological finding is objective and a gold standard to evaluate efficacy of NAC. In the present study, we tried to evaluate clinicaly efficacy objectively by calcurating tumor volume by esophagography and concordance between volume reduction rate and pathological efficacy. Methods: This retrospective study examined 53 patients who fullfilled the following criteria; (1) thoracic ESCC, (2) underwent resection following NAC between January 2011 and February 2017, and (3) T2-3N0 before surgey. Clinically, volume of the primary tumor was calculated by multiplying length and thickness in the lateral view of esophagography. Pathological efficacy was examined by the proportion of the tumor disappearance of the primary tumor and was classified as Grade 0-1 when degeneration area was < 2/3, Grade 2 when those area was > 2/3 and < 3/3, and Grade 3 when there was no residual tumor. Volume reduction rate calculrated by the difference of pre- and post-NAC was compared by stratifying pathological grade. Results: T2/T3 was 23/30, respectively. Regimen of neoadjuvant chemotherapy was 5-FU/CDDP in 50 patients,docetaxel/5-FU/CDDP in 1,and 5-FU/CDDP and Radiotherapy in 2. Overall volume reduction rate was 58.9% in median (range -127-100%). Pathological response (Grade 0-1/2/3) was 28/18/4, respectively. Median volume reduction rate (range) was 38.5% (-127-100%) in Grade 0-1, 72.2% (21.7-100%) in Grade 2, and 91.1% (75.5-100%) in Grade 3, which was significantly different (p < 0.01). Conclusions: The volume reduction rate of the primary tumor was correlated with pathological efficacy, suggesting that volume reduction rate could be a objective measure to evaluate efficacy of neoadjuvant chemotherapy for ESCC.

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