Neoadjuvant chemotherapy using concurrent docetaxel/CDDP/5-FU (DCF) in esophageal squamous cell carcinoma and its excellent short-term prognosis.

e15122 Background: Neoadjuvant chemotherapy (NAC) using 5-FU/CDDP (FP) followed by surgery is a standard treatment for esophageal squamous cell carcinoma (ESCC). However, this therapy often encountered progression during the early course of treatment. We are developing the novel NAC using Docetaxel/CDDP/5-FU (DCF). Methods: Thirty eight patients who underwent DCF NAC in cStage II/III ESCC was compared with the 41 counterparts treated by FP NAC. Docetaxel and CDDP were both given to 70-75 mg/ m2 with concurrent 5-FU at 750 mg/m2in 3 cycles. Median follow-up term of DCF NAC reached 18 months. Results: In DCF NAC, grade 3 adverse effects (AEs) were recognized in 97% (37/38), however non-hematological AEs exhibited 8% in stomatitis and 5% in anorexia, and completion rate of the DCF NAC was 86 %. In terms of PR+CR rate, DCF NAC was remarkably more excellent (33/38: 86.8%) than FP NAC (24/41: 58.5%)(P=0.0050). In DCF NAC therapy, 30 patients underwent surgery including 24 R0 esophagectomy, whereas another 8 patients selected definitive chemoradiation therapy. We experienced 3 patients with a pathologic complete response (ypCR)(10%) in DCF NAC. The 1st univariate prognostic analysis for progression free survival (PFS) among all the cases with NAC revealed that significant factors were R0 resection (P<0.0001), cT factor (P=0.0098), and NAC modality (P=0.1), and multivariate proportional hazard model identified these 3 factors as independent prognostic factors (IPFs). We then performed the 2nd stage multivariate prognostic analysis limited to R0 cases including pathologic factors for PFS. The univariate negative prognostic factors were FP NAC (P=0.0064), ypT3 (P=0.032), ypN3 (P=0.0017), ypv2/3 (P=0.0072), as well as cT3 (P=0.033), and multivariate analysis identified only NAC modality. DCF NAC was significantly associated with less frequency of ypT3 (P=0.019) and ypv2/3(P=0.013). Conclusions: Novel DCF NAC for ESCC demonstrated high response rates, and is promising for excellent survival in R0 cases, with acceptable feasibility. It improved the patient survival through downstage of the significant prognostic factors.

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PATHOLOGIC COMPLETE RESPONSE (YPT0 YPN0) AFTER CHEMOTHERAPY AND RADIOTHERAPY NEOADJUVANT FOLLOWED BY ESOPHAGECTOMY IN THE SQUAMOUS CELL CARCINOMA OF THE ESOPHAGUS

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-672020180001e1405 ◽

2018 ◽

Vol 31 (4) ◽

Cited By ~ 2

Author(s):

Nelson Adami ANDREOLLO ◽

Giovanni de Carvalho BERALDO ◽

Iuri Pedreira Filardi ALVES ◽

Valdir TERCIOTI-JUNIOR ◽

José Antonio Possato FERRER ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Neoadjuvant Chemotherapy ◽

Esophageal Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Pathologic Complete Response ◽

Neoadjuvant Treatment ◽

Complete Response ◽

Pathologic Response ◽

Admission Time

ABSTRACT Background: Esophageal squamous cell carcinoma is an aggressive neoplasia that requires a multidisciplinary treatment in which survival and prognosis are still not satisfactory. The complete pathologic response to neoadjuvant chemotherapy and radiotherapy is considered a good prognosis factor, and esophagectomy is indicated. Aim: Survival analysis of cases with pathologic complete response (ypT0 ypN0) to neoadjuvant chemotherapy and/or radiotherapy, submmitted to esophagectomy. Methods: Between 1983-2014, 222 esophagectomies were performed, and 177 were conducted to neoadjuvant treatment. In 34 patients the pathologic response was considered complete. Medical records of the patients were retrospectively reviewed regarding type of chemotherapy applied, amount of radiotherapy, interval between the neoadjuvant therapy and the surgery, body mass index; postoperative complications; hospital admission time and survival. Results: The average age was 55.8 years. Twenty-five patients were subjected to chemotherapy and radiotherapy, and nine to neoadjuvant radiotherapy. The total radiation dose ranged from 4400 until 5400 cGy. The chemotherapy was performed with 5FU, cisplatin, and carbotaxol, concomitantly with the radiotherapy. The esophagectomy was transmediastinal, followed by the cervical esophagogastroplasty performed on a average of 49.4 days after the neoadjuvant therapy. The hospital admission time was an average of 14.8 days. During the follow-up period, 52% of the patients submitted to radiotherapy and chemotherapy were disease-free, with 23.6% of them presenting more than five years survival. Conclusions: The neoadjuvant treatment followed by esophagectomy in patients with pathologic complete response is beneficial for the survival of patients with esophageal squamous cell carcinoma.

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PS02.100: ASSOCIATION BETWEEN RESPONSES OF NEOADJUVANT DOCETAXEL PLUS CISPLATIN AND FLUOROURACIL (DCF) CHEMOTHERAPY AND SURVIVALS IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA PATIENTS

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps02.100 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 149-149

Author(s):

Yasuyoshi Sato ◽

Hiroharu Yamashita ◽

Yasuhiro Okumura ◽

Kotaro Wakamatsu ◽

Masato Nishida ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Neoadjuvant Chemotherapy ◽

Esophageal Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Conflicts Of Interest ◽

Tnm Classification ◽

R0 Resection ◽

7Th Edition ◽

Phase Ii Studies

Abstract Background For patients with stage II/III esophageal squamous cell carcinoma (ESCC), neoadjuvant chemotherapy with cisplatin and 5-fluorouracil followed by surgery has been regarded as a standard treatment in Japan based on the result of Japan Clinical Oncology Group trial (JCOG9907). However, the survival outcome of this doublet chemotherapy has been still unsatisfactory especially in stage III patients. Triplet-regimen, consisting of docetaxel plus cisplatin and 5-fluorouracil (DCF), showed good responses and survivals in some previous phase II studies, and therefore neoadjuvant DCF seems promising for more advanced stage. We adopted neoadjuvant DCF chemotherapy for patients with advanced ESCC. Methods We retrospectively analyzed 48 patients with ESCC treated with DCF as neoadjuvant chemotherapy from January 2013 to October 2017 in our hospital. All patients were in clinical T3–4a/N1–2/M0 or T1b-2 with bulky lymph metastasis based on the TNM classification 7th edition. DCF regimen consisted of i.v. docetaxel (60–70 mg/m2) on day 1 and cisplatin (60–70 mg/m2) on day 1, and continuous infusion of fluorouracil (600–700 mg/m2) on days 1–5. This regimen was repeated every 4 weeks. Results Forty-six patients (96%) completed 2 cycles of DCF. According to revised RECIST guideline, response rate was 29% (CR, 2; PR, 12; SD, 14; PD, 8; Non-CR/non-PD, 12). Forty-two patients except PD underwent surgery; R0 resection was achieved in 40 patients. Among 34 patients observed for more than 1 year after initial treatment, 1 year survival rate and overall survival time were 72.7% [95%CI: 49.1–86.7] and 20.1 months [95%CI: 9.4–30.6] in SD, Non-CR/non-PD and PD patients, while no patients died at the 1 year and did not reach median survival in CR and PR group (P = 0.001). Conclusion Survival of advanced ESCC patients was strongly associated with the clinical response to neoadjuvant DCF. It might be an indicator to select good candidates for surgical therapy. Disclosure All authors have declared no conflicts of interest.

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Nomogram based on SIS predicting the survival of non-surgical thoracic esophageal squamous cell carcinoma treated by IMRT

10.21203/rs.3.rs-404753/v1 ◽

2021 ◽

Author(s):

Xingyu Du ◽

Shuchai Zhu ◽

Jing Dong ◽

Ke Yan ◽

Xiaobin Wang ◽

...

Keyword(s):

Overall Survival ◽

Squamous Cell Carcinoma ◽

Prognostic Factors ◽

Esophageal Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Inflammatory Markers ◽

Progression Free Survival ◽

Data Set ◽

Free Survival

Abstract Background: Several inflammatory markers have been reported to be associated with clinical outcomes in patients with esophageal squamous cell carcinoma (ESCC). This study was to evaluate several pre-radiotherapy serum inflammatory indicators, including the neutrophil / lymphocytes ratio (NLR), platelet / lymphocyte (PLR), systemic immune-inflammatory index (SII), systemic inflammation score(SIS), and compare which one has the highest predicted survival value. Finally, combining inflammatory markers with traditional prognostic factors, a new Nomogram model was developed to predict overall survival (OS) and progression-free survival (PFS) for ESCC patients receiving radiotherapy (RT) or chemoradiotherapy (CRT). Methods: This study retrospectively reviewed the data of 245 patients with thoracic esophageal squamous cell carcinoma (ESCC) underwent RT or CRT in the Fourth Hospital of Hebei Medical University from January 2013 to December 2015. The survival differences of these indexes were compared by the Kaplan-Meier method, and the univariate and the multivariate analyses were performed to determine these prognostic factors of overall survival (OS) and progression-free survival (PFS). Multivariate Cox proportional hazards regression models were used to create nomogram for OS and PFS.Results: 239 patients met the eligibility criteria. The estimated 1-, 3-, and 5-year OS and PFS rates were 74.6%, 36.8%, 26.5% and 58.4%, 31.3%, 20.5%, respectively, for the whole group. The difference in survival between OS and PFS was significant when univariate analysis were applied based on these inflammation-based measures. Multivariate analysis showed that tumor length, T stage, TNM stage, chemotherapy, SIS were predictive variables for OS and PFS in the multivariate model. The nomogram model established based on multivariate models of training data set had good predictive ability, the unadjusted C-index was 0.701 (95% CI, 0.662– 0.740) and 0.695 (95% CI, 0.656 - 0.734) for OS and PFS. Conclusions: This study show that SIS, as a comprehensive indicator of inflammation and nutrition, had the strongest predictive power for evaluating prognosis. Moreover, our nomogram can accurately predict OS and PFS after treatment and may provide guidance regarding adjuvant therapy and surveillance.

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