Effects of plasma concentrations of 5-fluorouracil on long-term survival after treatment with a definitive 5-fluorouracil/cisplatin-based chemoradiotherapy in Japanese patients with esophageal squamous cell carcinoma

Journal of Experimental & Clinical Cancer Research

Toshiyuki Sakaeda³  Hideaki Omatsu²  Tatsuya Okuno²  Takao Tamura²  Ikuya Miki²  Tsutomu Nakamura²  Kohshi Nishiguchi¹  Kaori Kadoyama³  Motohiro Yamamori²  Akiko Kuwahara² 

[1] Faculty of Pharmaceutical Sciences, Kyoto Pharmaceutical University, Kyoto 607-8414, Japan;Kobe University Graduate School of Medicine, Kobe 650-0017, Japan;Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501, Japan

关键词: prognosis;    clinical outcome;    plasma concentration;    5-fluorouracil;    esophageal squamous cell carcinoma;   

Others  :  827195
DOI  :  10.1186/1756-9966-30-94

 received in 2011-08-10, accepted in 2011-10-05,  发布年份 2011

【 摘 要 】

Background

A substantial body of literature has accumulated during the past 20 years showing the plasma concentrations of 5-fluorouracil (5-FU) to correlate with clinical response and/or toxicity in colorectal cancer, and head and neck cancer, but little information is available concerning effects on long-term survival. Here, Japanese patients with esophageal squamous cell carcinoma (ESCC) were followed up for 5 years after treatment with a definitive 5-FU/cisplatin (CDDP)-based chemoradiotherapy (CRT), and the association between prognosis and the plasma concentration of 5-FU was evaluated.

Methods

Forty-nine patients with ESCC, who were treated with a definitive 5-FU/CDDP-based CRT, were enrolled. A course consisted of the continuous infusion of 5-FU at 400 mg/m²/day for days 1-5 and 8-12, the infusion of CDDP at 40 mg/m²/day on days 1 and 8, and the radiation at 2 Gy/day on days 1 to 5, 8 to 12, and 15 to 19, with a second course repeated after a 2-week interval. Plasma concentrations of 5-FU were determined by high performance liquid chromatography at 5:00 PM on days 3, 10, 38 and 45, and at 5:00 AM on days 4, 11, 39 and 46.

Results

The overall 5-year survival rate was 42.9%. Age (P = 0.020), body weight (P = 0.019), and disease stage (P = 0.048) affected the survival, and the survival depended on the clinical response assessed at 1 month after the treatment (P = 0.001). Higher plasma concentrations of 5-FU resulted in a better clinical response (P = 0.043), and trended to prolong survival (P = 0.321).

Conclusions

The long-term survival after treatment with a definitive 5-FU/CDDP-based CRT possibly depends on the plasma concentrations of 5-FU, and further clinical studies with a larger number of cases are needed to clarify the relationship between them.

【 授权许可】

   
2011 Kuwahara et al; licensee BioMed Central Ltd.

【 图 表 】

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