title: Efficacy and feasibility of ambulatory treatment-based monthly nedaplatin plus S-1 in definitive or salvage concurrent chemoradiotherapy for early, advanced, and relapsed esophageal cancer.
abstract: BACKGROUND
  Standard chemoradiotherapy (CRT) using cisplatin (CDDP) and 5-fluorouracil (5-FU) is an optional treatment for patients with stage II-III esophageal cancer. However, there are some demerits in this regimen because CDDP administration requires a large transfusion volume and 5-FU must be continuously infused over 24 h. Therefore, hospitalization is unavoidable. We collected retrospectively the data of definitive CRT with nedaplatin and S-1 as carried out in our institution.
  
  
  METHODS
  Patients with early and advanced esophageal cancer and relapsed esophageal cancer after radical surgery were included. Nedaplatin 80 mg/m(2) was given on days 1 and 29, and S-1 80 mg/m(2) on days 1-14 and 29-42. No prophylactic treatment with granulocyte colony stimulating factor was administered. Patients received two courses of concurrent radiotherapy of more than 50 Gy with or without two additional courses as adjuvant therapy every 4 weeks.
  
  
  RESULTS
  Between August 2011 and June 2015, 89 patients (age range, 44-86 years; K-PS 90-100, 81 %; squamous cell carcinoma histology, 97 %; definitive/salvage CRT, 75/25 %) were collected. Twenty-one (24 %) patients completed four cycles, and 94 % received two or more cycles. Grade 4 leukopenia, thrombocytopenia, and anemia occurred in 12, 7, and 10 % of the patients, respectively. Five patients developed febrile neutropenia. Grade 3 non-hematological toxicity included infection in 12 %, mucositis/esophagitis in 3 %, kidney in 3 %, and fatigue in 3 %. Sixty-four patients (72 %) received the prescribed full dose and full cycles of chemotherapy. A complete response was achieved in 76 patients (85 %). The 3-year overall survival rate was 54.4 % in definitive CRT and 39.8 % in salvage CRT, respectively. Sixty-two subjects (70 %) received treatment as outpatients.
  
  
  CONCLUSIONS
  Nedaplatin and S-1 in combination with radiotherapy is feasible, and toxicity is tolerable. This treatment method has the potential to shorten hospitalization without impairing the efficacy of CRT.
authors.affiliation: Department of Radiology, University of Tokyo Hospital of Bunkyo-ku, Tokyo, Japan. yamachan07291973@yahoo.co.jp.
authors.forename: Hideomi
authors.initials: H
authors.lastname: Yamashita
authors.affiliation: Department of Radiology, University of Tokyo Hospital of Bunkyo-ku, Tokyo, Japan. haga-haga@umin.ac.jp.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Haga
authors.affiliation: Department of Radiology, University of Tokyo Hospital of Bunkyo-ku, Tokyo, Japan. TAKENAKAR-RAD@h.u-tokyo.ac.jp.
authors.forename: Ryousuke
authors.initials: R
authors.lastname: Takenaka
authors.affiliation: Department of Radiology, University of Tokyo Hospital of Bunkyo-ku, Tokyo, Japan. kiritooshi-ykh@umin.ac.jp.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Kiritoshi
authors.affiliation: Department of Radiology, University of Tokyo Hospital of Bunkyo-ku, Tokyo, Japan. kaebear7@yahoo.co.jp.
authors.forename: Kae
authors.initials: K
authors.lastname: Okuma
authors.affiliation: Department of Radiology, University of Tokyo Hospital of Bunkyo-ku, Tokyo, Japan. kotomo-tky@umin.ac.jp.
authors.forename: Kuni
authors.initials: K
authors.lastname: Ohtomo
authors.affiliation: Department of Radiology, University of Tokyo Hospital of Bunkyo-ku, Tokyo, Japan. k-nak@fg7.so-net.ne.jp.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Nakagawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000532:radiotherapy*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004338:Drug Combinations; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage*; D010094:Oxonic Acid / Q000008:administration & dosage*; D012189:Retrospective Studies; D016879:Salvage Therapy; D005641:Tegafur / Q000008:administration & dosage*
chemical_list: D004338:Drug Combinations; D009944:Organoplatinum Compounds; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; C053989:nedaplatin; D002945:Cisplatin; D005472:Fluorouracil