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Long-term results of chemoradiotherapy for locally advanced esophageal cancer, using daily low-dose 5-fluorouracil and cis-diammine-dichloro-platinum (CDDP)

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Abstract

Background

We evaluated the efficacy and toxicity of radiation combined with daily, low-dose protracted chemotherapy for locally advanced esophageal cancer.

Methods

We analyzed data for 68 patients with locally advanced esophageal cancer, including 18 surgical candidates. Standard fractionation (total dose range, 60 to 70 Gy) was used for radiotherapy. The chemotherapy consisted of a daily 5-fluorouracil dose of 250 mg/m2, with a cis-diammine-dichloro-platinum dose of 3 mg/m2 administered on radiotherapy days.

Results

Sixty-four patients (94%) received at least 60 Gy. Grade 3 acute hematological toxicity was observed in 13 (19%) patients; there was no grade 4 hematological toxicity. Complete response, partial response, no change, and progressive disease were obtained in 22, 35, 7, and 4 patients, respectively. Minimum follow-up for surviving patients was 45 months. Locoregional progression-free rates at 3 and 5 years were 47% and 47%. Four patients died of late cardiac toxicity; the primary site for all 4 patients was the middle thoracic esophagus. Overall survival rates at 2, 3, and 5 years were 40%, 32%, and 20%. The 3- and 5-year survival rates in patients with T2-3M0 disease were 43% and 27%, and the rates were 24% and 15% in patients with T4/M1.

Conclusion

Given the large proportion of patients in this study with inoperable disease (roughly three quarters), our treatment seemed to provide equivalent efficacy and less hematological toxicity than standard-dose chemoradiotherapy.

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Authors and Affiliations

  1. Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan

    Ryuta Sasamoto, Emiko Tsuchida, Tadayoshi Yamanoi, Eisuke Abe, Nobuko Yamana & Keisuke Sasai

  2. Niigata Chemoradiation Study Group, Niigata, Japan

    Kunio Sakai, Hideki Inakoshi, Hiroo Sueyama, Mari Saito, Tadashi Sugita, Takeshi Ito & Yasuo Matsumoto

Authors
  1. Ryuta Sasamoto
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  2. Kunio Sakai
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  3. Hideki Inakoshi
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  4. Hiroo Sueyama
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  5. Mari Saito
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  6. Tadashi Sugita
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  7. Emiko Tsuchida
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  8. Takeshi Ito
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  9. Yasuo Matsumoto
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  10. Tadayoshi Yamanoi
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  11. Eisuke Abe
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  12. Nobuko Yamana
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  13. Keisuke Sasai
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Corresponding author

Correspondence to Ryuta Sasamoto.

Additional information

All members of this group are affiliated with department of Radiology in their institutes

Part of this report was presented at the 46th annual meeting of American Society for Therapeutic Radiology and Oncology

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Sasamoto, R., Sakai, K., Inakoshi, H. et al. Long-term results of chemoradiotherapy for locally advanced esophageal cancer, using daily low-dose 5-fluorouracil and cis-diammine-dichloro-platinum (CDDP). Int J Clin Oncol 12, 25–30 (2007). https://doi.org/10.1007/s10147-006-0617-y

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  • DOI: https://doi.org/10.1007/s10147-006-0617-y

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