Long-term bresults of radiotherapy combined with nedaplatin and 5-fluorouracil for postoperative loco-regional recurrent esophageal cancer: update on a phase II study

BMC Cancer

Keiichi Jingu¹  Haruo Matsushita¹  Ken Takeda¹  Rei Umezawa¹  Chiaki Takahashi¹  Toshiyuki Sugawara¹  Masaki Kubozono¹  Keiko Abe¹  Takaya Tanabe¹  Yuko Shirata¹  Takaya Yamamoto¹  Youjirou Ishikawa¹  Kenji Nemoto² 

[1] Department of Radiation Oncology, Tohoku University School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan

[2] Department of Radiation Oncology, Yamagata University School of Medicine, Yamagata, Japan

关键词: Phase II study;    Long-term results;    Chemoradiotherapy;    Postoperative recurrent esophageal cancer;   

Others  :  1080069
DOI  :  10.1186/1471-2407-12-542

 received in 2012-08-08, accepted in 2012-11-20,  发布年份 2012

【 摘 要 】

Background

In 2006, we reported the effectiveness of chemoradiotherapy for postoperative recurrent esophageal cancer with a median observation period of 18 months. The purpose of the present study was to update the results of radiotherapy combined with nedaplatin and 5-fluorouracil (5-FU) for postoperative loco-regional recurrent esophageal cancer.

Methods

Between 2000 and 2004, we performed a phase II study on treatment of postoperative loco-regional recurrent esophageal cancer with radiotherapy (60 Gy/30 fractions/6 weeks) combined with chemotherapy consisting of two cycles of nedaplatin (70 mg/m²/2 h) and 5-FU (500 mg/m²/24 h for 5 days).

The primary endpoint was overall survival rate, and the secondary endpoints were progression-free survival rate, irradiated-field control rate and chronic toxicity.

Results

A total of 30 patients were enrolled in this study. The regimen was completed in 76.7% of the patients. The median observation period for survivors was 72.0 months. The 5-year overall survival rate was 27.0% with a median survival period of 21.0 months. The 5-year progression-free survival rate and irradiated-field control rate were 25.1% and 71.5%, respectively. Grade 3 or higher late toxicity was observed in only one patient. Two long-term survivors had gastric tube cancer more than 5 years after chemoradiotherapy.

Pretreatment performance status, pattern of recurrence (worse for patients with anastomotic recurrence) and number of recurrent lesions (worse for patients with multiple recurrent lesions) were statistically significant prognostic factors for overall survival.

Conclusions

Radiotherapy combined with nedaplatin and 5-FU is a safe and effective salvage treatment for postoperative loco-regional recurrent esophageal cancer. However, the prognosis of patients with multiple regional recurrence or anastomotic recurrence is very poor.

【 授权许可】

   
2012 Jingu et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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