Concurrent Chemoradiotherapy with a Novel Fluoropyrimidine, S-1, and Cisplatin for Locally Advanced Esophageal Cancer: Long-Term Results of a Phase II TrialIwase H.a · Shimada M.a · Tsuzuki T.a · Hirashima N.a · Okeya M.a · Hibino Y.a · Ryuge N.a · Yokoi M.a · Kida Y.a · Kuno T.a · Tanaka Y.a · Kato B.a · Esaki M.a · Urata N.a · Kato E.b
Departments of aGastroenterology and bRadiology, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
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Objectives: A phase II study was performed to investigate the safety and efficacy of concurrent chemoradiotherapy (CCRT) combined with an orally active fluoropyrimidine, S-1, plus cisplatin for locally advanced esophageal cancer (LAEC). Methods: CCRT comprised 2 courses, a 30-Gy radiotherapy over 3 weeks plus daily oral S-1 (80 mg/m2/day) for 2 weeks and a 24-hour cisplatin infusion (70 mg/m2) on day 8, and an identical course administered after a 2-week break. Results: One hundred and sixteen patients, 12 with stage II, 71 with stage III, and 33 with stage IVa LAEC participated, and 106 of them (91.4%) completed the CCRT course. The most serious toxicity was myelosuppression: grade 3 and 4 neutropenia occurred in 28.4 and 9.5% of patients, respectively. Nonhematologic toxicity was moderate. Complete response rates in patients with stage II, III, and IVa LAEC were 91.7, 67.6, and 36.4%, respectively. The overall median survival time was 2.3 years and that of patients with stage II, III, and IVa cancer was 7.0, 2.6, and 1.3 years, respectively. Conclusions: CCRT combined with S-1 plus cisplatin showed promising safety and efficacy. Potentially, this combination therapy could become a baseline medication for patients with LAEC.
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