title: Concurrent chemoradiotherapy with protracted infusion of 5-fluorouracil (5-FU) and cisplatin for locally advanced resectable esophageal cancer.
abstract: BACKGROUND
  Neoadjuvant concurrent chemoradiotherapy (CCRT) has become the standard treatment for esophageal cancer (EC) in North America. The cisplatin/5-flurouracil (5-FU) combination has been the most commonly used regimen. For the last 15 years we incorporated a daily continuous infusion of 5-FU and 2 doses of cisplatin into our neoadjuvant CCRT for potentially resectable EC.
  
  
  METHODS
  Between July 1997 and June 2012, 129 patients with locally advanced EC (T3 or N1 and higher), received neoadjuvant CCRT with cisplatin 75 mg/m(2) on day 1 and day 29 and continuous infusion of 5-FU (225 mg/m(2)/day) on the days of radiation.
  
  
  RESULTS
  The median age of patients was 63 years, 85% had adenocarcinoma, 29, 74 and 26 patients had stage II, III and IVa disease respectively, 110 patients had N1 disease based on the American Joint Committee on Cancer (AJCC) 6(th) edition, 118 patients experienced weight loss during treatment. All patients completed treatment. Treatment was well tolerated with 14% of patients having ≥ grade 3 toxicity and 18 patients requiring hospital admission. Sixty-four percent of patients had surgical resection following CCRT, with disease progression and patient refusal being the most common reasons for not proceeding with surgery. An R0 resection was achieved in 96% of patients. A pathological complete response (pCR) was achieved in 45% of patients. With a median follow up of 26 months (1.2-144 months), 48/129 patients recurred and 60/129 died of their disease.
  
  
  CONCLUSIONS
  Our study has its limitation, however, and compared to the conventional chemotherapy regimens containing the cisplatin/5-FU doublet, our treatment strategy for locally advanced EC CCRT seems to be feasible and well tolerated.
authors: 1 Department of Gastrointestinal Oncology, 2 Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.
authors: Khaldoun
authors: K
authors: Almhanna
authors: 1 Department of Gastrointestinal Oncology, 2 Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.
authors: Sarah
authors: S
authors: Hoffe
authors: 1 Department of Gastrointestinal Oncology, 2 Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.
authors: Jonathan
authors: J
authors: Strosberg
authors: 1 Department of Gastrointestinal Oncology, 2 Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.
authors: William
authors: W
authors: Dinwoodie
authors: 1 Department of Gastrointestinal Oncology, 2 Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.
authors: Kenneth
authors: K
authors: Meredith
authors: 1 Department of Gastrointestinal Oncology, 2 Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.
authors: Ravi
authors: R
authors: Shridhar
keywords: 5-fluorouracil (5-FU); cisplatin; esophageal cancer (EC)
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