Second-line combination chemotherapy with docetaxel for cisplatin-pretreated refractory metastatic esophageal cancer: a preliminary report of initial experience.
OBJECTIVE
Patients with esophageal cancer often develop metastatic disease after esophageal resection and generally receive cisplatin-based chemotherapy or chemoradiotherapy. The efficacy and toxicity of the combination of docetaxel, 5-fluorouracil (5-FU) and cisplatin (DFC) as a second-line chemotherapy were evaluated in patients with postoperative metastatic esophageal cancer refractory to cisplatin-based chemotherapy.


METHODS
Twenty patients with metastatic esophageal cancer after esophagectomy refractory to cisplatin-based therapy were included in this study. The DFC regimen consisted of docetaxel (60 mg/m(2)) on day 1, 5-FU (500 mg/day) on days 1-5 and cisplatin (10 mg/day) on days 1-5, being repeated every 3 weeks.


RESULTS
A total of 49 cycles (median 2, range 1-6) was administered to 20 patients. The median follow-up was 8 months (range 3-24). Of the 20 patients, 1 had a complete response, 6 had a partial response, 6 had stable and 7 had progressive disease. Median time to progression for all patients was 4 months (95% Cl 1.7-5.6). The median overall survival for all patients was 8 months (95% CI 5.7-10.3). The major toxicity was myelosuppression. Neutropenia of grade 3 or more occurred in 13 patients (65%), and thrombocytopenia of grade 3 occurred in 1 patient (5%). Febrile neutropenia was observed in 1 patient (5%). There was no treatment-related mortality.


CONCLUSIONS
DFC is a feasible and promising regimen as a second-line therapy in metastatic/recurrent esophageal cancer refractory to cisplatin-based chemotherapy.
Tanaka
Toshiaki
T
Department of Surgery, Kurume University School of Medicine, Kurume, Japan. totanaka@med.kurume-u.ac.jp
Fujita
Hiromasa
H
Sueyoshi
Susumu
S
Tanaka
Yuichi
Y
Sasahara
Hiroko
H
Mori
Naoki
N
Nagano
Tsuyoshi
T
Yamana
Hideaki
H
Shirouzu
Kazuo
K
D000310:Adrenal Gland Neoplasms / Q000188:drug therapy / Q000556:secondary; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D016879:Salvage Therapy; D015996:Survival Rate; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome
D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil