Neoadjuvant chemotherapy and hyperfractionated radiotherapy with concurrent low-dose chemotherapy for squamous cell esophageal carcinoma
| Autor: | Bernard Launois, Jean-Pierre Campion, Bernard Meunier, Jean-Luc Raoul, Denis Heresbach, Elisabeth Le Prisé |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Esophageal Neoplasms medicine.medical_treatment Antidotes Leucovorin Gastroenterology Folinic acid Low-dose chemotherapy Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Carcinoma Mucositis Humans Radiology Nuclear Medicine and imaging Prospective Studies Neoadjuvant therapy Radiation Esophageal disease business.industry Radiotherapy Dosage Middle Aged medicine.disease Surgery Radiation therapy Treatment Outcome Oncology Epidermoid carcinoma Chemotherapy Adjuvant Carcinoma Squamous Cell Female Fluorouracil Cisplatin business medicine.drug |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 42:29-34 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/s0360-3016(98)00192-8 |
| Popis: | Purpose: We conducted a prospective study of neoadjuvant treatment for squamous cell carcinoma of the esophagus, modifying the chemotherapy protocol by adding l -folinic acid and giving bifractionated radiotherapy with a cis -diaminedichloroplatinum (CDDP) injection before each fraction. Methods and Materials: Thirty-two patients, 30 men, 2 women, mean age 56.2 ± 8.9 years, with resectable squamous cell carcinoma of the esophagus (TNM stage I=4, IIA=4, IIB=13, III=11) were included. Chemotherapy, CDDP (80 mg/m 2 D2), 5-fluorouracil (5-FU; 600 mg/m 2 , D1–4), and l -folinic acid (200 mg/m 2 , D1–4), was given in two sessions with a 3-week interval during which the patients received radiotherapy (45 Gy), two fractions per day (150 cGy/fraction). A 3-mg injection of CDDP was given prior to each fraction. Patients underwent surgery 4 to 7 weeks after neoadjuvant therapy. Results: No severe side effects were observed in 12 patients. Grade 3 effects (WBC, platelets, mucositis) occurred in 16 patients and grade 4 effects (platelets, mucositis) in four including 1 death due to septicemia with an infected catheter. Surgery was performed in 29 patients; 26 had resectable tumors (81%). Operative mortality was 10%. The 26 surgical specimens showed complete response ( n = 18), persistent microscopic residues ( n = 4), or not significant modification ( n = 4). Survival at 1, 2, and 3 years was 81, 61, and 51.6% and disease-free survival was 75, 59, and 54% respectively. Conclusions: This new therapeutic combination is aggressive and associated with a high postoperative mortality but has a remarkable histological effect since complete response was achieved in 56% (95% CI: 39–73%) of the patients and 3-year survival reached 52%, a very high rate in our experience. |
| Databáze: | OpenAIRE |
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