Japanese Journal of Clinical Oncology 33:341-345 (2003)
© 2003 Foundation for Promotion of Cancer Research
Concurrent Chemoradiotherapy with Protracted Infusion of 5-FU and Cisplatin for Postoperative Recurrent or Residual Esophageal Cancer
1 Department of Radiology and 2 Department of Surgery, Kinki University School of Medicine, Osaka-Sayama, Osaka and 3 Radiation Oncology Research Laboratory, Research Reactor Institute, Kyoto University, Sennan-gun, Osaka, Japan
Background: We carried out the present study to investigate the feasibility and effectiveness of concurrent chemoradiotherapy (CT-RT) for postoperative recurrent esophageal cancer, which are, at present, unclear.
Methods: Between 1998 and 2002, 16 patients with postoperative loco-regional recurrence of esophageal cancer, and two patients with incompletely resected esophageal cancer were treated with concurrent CT-RT. Patients received protracted infusion of 5-FU 250–300 mg/m2 on days 1 to 14, 1 hour infusion of cisplatin 10 mg/body on days 1 to 5 and 8 to 12, and a concurrent radiotherapy (RT) dose of 30 Gy in 15 fractions over 3 weeks. This treatment schedule was repeated twice with a gap of 1 week, for a total RT dose of 60 Gy administered over 7 weeks.
Results: Of the 18 patients, 13 (72%) completed the CT-RT protocol. A total RT dose of 60 Gy was administered for all except two patients, and doses of chemotherapy were reduced for five patients. Although grade 3 hematological toxicities were frequently noted, non-hematological toxicities of grades 3 and 4 were few. Of the 18 tumors, five (28%) showed complete response (CR). For patients without prior chemotherapy, the CR rate was 40% (4/10). The 2-year survival rate of 13 patients without distant metastases was 19%, with a median survival time of 9.5 months.
Conclusion: The concurrent CT-RT protocol appears feasible and effective for patients with postoperative recurrent or residual esophageal cancer.
+ For reprints and all correspondence: Yasumasa Nishimura, Department of Radiology, Kinki University School of Medicine, 377–2, Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan. E-mail: ynishi{at}med.kindai.ac.jp
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