title: Feasibility of Preoperative Chemotherapy with Docetaxel, Cisplatin, and 5-Fluorouracil versus Adriamycin, Cisplatin, and 5-Fluorouracil for Resectable Advanced Esophageal Cancer.
abstract: BACKGROUND
  Neoadjuvant chemotherapy for resectable advanced esophageal squamous cell carcinoma (ESCC) requires reassessment. We have conducted a trial aiming at the comparison between DCF and ACF concerning perioperative adverse events.
  
  
  METHODS
  Patients were randomly assigned to receive either DCF [docetaxel 70 mg/m2, cisplatin 70 mg/m2 on day 1, and 5-fluorouracil (5-FU) 700 mg/m2 for 5 days] every 3 weeks or ACF (adriamycin 35 mg/m2, cisplatin 70 mg/m2 on day 1, and 5-FU 700 mg/m2 for 7 days) every 4 weeks. Each group consisted of 81 patients. Two cycles of preoperative chemotherapy were planned, after which patients underwent subtotal esophagectomy via a right thoracotomy with lymphadenectomy. Chemotherapy- and surgery-related adverse effects were assessed.
  
  
  RESULTS
  Grade 3-4 neutropenia and febrile neutropenia occurred in 90 and 39% of patients, respectively, in the DCF group compared with 69 and 17% of patients, respectively, in the ACF group (p < 0.01). Perioperative complications did not differ significantly between the groups. The overall response rates of DCF and ACF were 61 and 40%, respectively, while the histopathological complete responses were 15 and 3%, respectively (p < 0.01).
  
  
  CONCLUSIONS
  The DCF and ACF regimens were found to be equally feasible in patients with resectable advanced ESCC; however, DCF delivered an antitumor effect and therefore potentially improved the long-term outcomes.
authors.affiliation: Department of Surgery, Kindai University Faculty of Medicine, Osakasayama, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Shiraishi
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Tomoki
authors.initials: T
authors.lastname: Makino
authors.forename: Masaaki
authors.initials: M
authors.lastname: Motoori
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miyata
authors.forename: Masayuki
authors.initials: M
authors.lastname: Shinkai
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kimura
authors.forename: Motohiro
authors.initials: M
authors.lastname: Hirao
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Fujitani
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Tamura
authors.forename: Kenji
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Yano
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.forename: Takushi
authors.initials: T
authors.lastname: Yasuda
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D004317:Doxorubicin / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D043823:Taxoids / Q000008:administration & dosage
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D004317:Doxorubicin; D002945:Cisplatin; D005472:Fluorouracil