title: Long-term results of radiotherapy combined with nedaplatin and 5-fluorouracil for postoperative loco-regional recurrent esophageal cancer: update on a phase II study.
abstract: 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.
authors.affiliation: Department of Radiation Oncology, Tohoku University School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan. kjingu-jr@rad.med.tohoku.ac.jp
authors.forename: Keiichi
authors.initials: K
authors.lastname: Jingu
authors.forename: Haruo
authors.initials: H
authors.lastname: Matsushita
authors.forename: Ken
authors.initials: K
authors.lastname: Takeda
authors.forename: Rei
authors.initials: R
authors.lastname: Umezawa
authors.forename: Chiaki
authors.initials: C
authors.lastname: Takahashi
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Sugawara
authors.forename: Masaki
authors.initials: M
authors.lastname: Kubozono
authors.forename: Keiko
authors.initials: K
authors.lastname: Abe
authors.forename: Takaya
authors.initials: T
authors.lastname: Tanabe
authors.forename: Yuko
authors.initials: Y
authors.lastname: Shirata
authors.forename: Takaya
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Youjirou
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Nemoto
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D059248:Chemoradiotherapy / Q000009:adverse effects; D004334:Drug Administration Schedule; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D011184:Postoperative Period; D011379:Prognosis; D013274:Stomach Neoplasms / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; C053989:nedaplatin; D005472:Fluorouracil