Japanese Journal of Clinical Oncology, Vol 29, Issue 3 132-136, Copyright © 1999 by Foundation for Promotion of Cancer Research
S Shimoyama, T Konishi, M Kawahara, M Kaminishi, A Ito, K Hojo, Y Takeda, H Oba and S Shimizu
BACKGROUND: A combination of chemotherapy and radiotherapy (chemoradiation
therapy; CRT) has recently been developed to improve the survival of
esophageal cancer patients. However, the optimal choice of chemotherapeutic
agents and their doses, as well as chemotherapy and radiotherapy regimens,
remain unclear. METHODS: Based on recent advances in knowledge on the
radiosensitizing and biochemical modulation effects of chemotherapeutic
agents, we have recently developed concurrent CRT which consisted of
continuous 5-fluorouracil (5FU) administration (600 mg/m2/day, days 1-5)
combined with a low dose of daily cisplatin administration (10 mg/m2/day,
days 1-5, and 5 or 10 mg/m2/day, days 8-12 and 15-19) before each fraction
of radiation (2 Gy each). To evaluate the efficacy and safety of our
concurrent CRT, 10 esophageal cancer patients received one or one and a
half courses of the CRT. RESULTS: All patients tolerated and completed a
full course of the CRT. The effectiveness of the CRT on the primary tumor
included pathologically or endoscopically complete responses in three
patients (30%), partial response in five (50%), no response in two (20%)
and tumoral downstaging (T-classification) in five (50%). Grade 2 and Grade
3 toxicity, seen in six patients, did not affect surgical operation. No
patients showed CRT-related deaths. Eight patients (80%) underwent
resection with no operative mortality. Of these, two patients (25%) showed
pathologically or endoscopically complete responses, and four (50%) showed
partial response. Three patients died of cancer after resection. The two
inoperable patients showed a pathologically complete response and partial
response, respectively. They were relieved of their cancer-related
complaints and were living without hospitalization at the time of this
analysis. CONCLUSIONS: These results suggest that the concurrent CRT based
on the theoretical backgrounds is effective and has acceptable toxicities
with maintaining its efficacy for the treatment of esophageal cancer
patients.
CASE REPORTS
Pre-operative chemoradiation therapy with 5-fluorouracil and low-dose daily cisplatin for esophageal cancer: a preliminary report
Department of Surgery, Showa General Hospital, Kodaira, Tokyo, Japan.
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