演題抄録

International Workshop

開催概要
開催回
第54回・2016年・横浜
 

Significance of initial induction chemotherapy with 5-fluorouracil, cisplatin, and docetaxel (DCF) for T4 esophageal cancer―A Propensity Score-matched Analysis―

演題番号 : IWS3-1

[筆頭演者]
牧野 知紀:1 
[共同演者]
山崎 誠:1、田中 晃司:1、宮崎 安弘:1、和田 範子:1、高橋 剛:1、黒川 幸典:1、中島 清一:1、瀧口 修司:1、森 正樹:1、土岐 祐一郎:1

1:大阪大学・大学院医学系研究科・消化器外科

 

Objective: To establish optimal induction treatments for esophageal squamous cell carcinoma (ESCC) invading adjacent organs (T4).
Background: Surgery would allow patients an opportunity for long survival if the tumor can be completely removed, regardless of T stage. Therefore, establishing effective induction treatments is crucial for T4 ESCC in order to alter an unresectable status and achieve curative resection.
Methods: Fifty consecutive patients with T4 ESCC without distant metastasis who underwent initial induction chemotherapy using cisplatin and 5-FU (CF) plus docetaxel (DCF) were propensity score-matched with 50 patients who underwent chemoradiotherapy (CRT) concurrent with CF. For the DCF group, CRT was subsequently applied when surgical resection was not indicated.
Results: In the DCF group, 24 (48.0%) patients underwent surgery, achieving a 64% clinical response rate, compared to 72.0% for induction CRT. CRT was performed in another 24 (48.0%) patients in the DCF group. Overall resectability was significantly higher in the DCF group than the CRT group (79.0% vs. 45.7%, p=0.0017). The esophageal perforation rate during induction treatments was significantly lower in the DCF group compared to the CRT group (4.0% vs. 18.0%, p=0.0205). The DCF group was associated with a significantly better prognosis than the CRT group (5-year cause-specific survival 42.1% vs. 22.2%, p=0.0146).
Conclusions: Induction DCF chemotherapy reduced esophageal perforation and increased the overall resectability in patients with T4 ESCC, leading to the better survival than CRT alone. DCF chemotherapy may be an effective and safe option for initial induction treatment of T4 ESCC.

キーワード

臓器別:食道

手法別:化学療法

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