[Radiotherapy combined with S-1 and cisplatin for locally advanced and metastatic esophageal cancer].
BACKGROUND
Chemoradiotherapy combined with 5-fluorouracil and cisplatin have been effective for the treatment of advanced esophageal cancer, but superior treatments are needed. We prospectively analyzed the efficacy of concurrent chemoradiotherapy using oral fluoropyrimidine (S-1) and cisplatin for the treatment of advanced esophageal cancer.


METHODS
The treatment protocol was determined on a phase I study. The first chemoradiotherapy course consisted of 30 Gy over 3 weeks, a daily oral administration of S-1 (80 mg/m2/day) for 2 weeks, and a 24-hour infusion of cisplatin (70 mg/M2) on day 8. A second course of chemoradiotherapy was performed after an interval of 2 weeks.


RESULTS
Seventy-one patients entered to this phase II study for five years (stage II: n=6, stage III: n=40, stage IV: n=25). All the stage II patients obtained a complete response, while 55% and 93% of the stage III patients and 20% and 76% of the stage IV patients obtained complete and partial responses, respectively. The major toxicity was myelosuppression. Eight patients (11%)developed a grade 4 leukocytopenia. The median survival times were thirty-nine months and eleven months for the stage II + stage III and stage IV patients, respectively.


CONCLUSIONS
Chemoradiotherapy combined with S-1 and cisplatin may be a promising treatment option for advanced esophageal cancer.
Iwase
Hiroaki
H
Dept. of Gastroenterology, Nagoya Medical Center, Japan.
D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000139:chemically induced; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D004338:Drug Combinations; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010094:Oxonic Acid / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D015996:Survival Rate; D005641:Tegafur / Q000008:administration & dosage / Q000009:adverse effects; D013921:Thrombocytopenia / Q000139:chemically induced
D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin