演題抄録

International Workshop

開催概要
開催回
第54回・2016年・横浜
 

Prognostic advantage of DTX/CDDP/5-FU neoadjuvant chemotherapy in clinical stage Ⅱ/Ⅲ esophageal squamous cell carcinoma

演題番号 : IWS3-2

[筆頭演者]
山下 継史:1 
[共同演者]
森谷 宏光:1、細田 桂:1、三重野 浩朗:1、江間 玲:1、鷲尾 真理愛:1、渡邊 昌彦:1

1:北里大学・病院・外科

 

Background Neoadjuvant chemotherapy (NAC) for cStage II/III esophageal squamous cell carcinoma (ESCC) becomes prevalent in Japan, however long-term prognostic advantages remain unclear. In this study, we elucidated the latest prognostic traits in cStage II/III ESCC with NAC.
Patients and methods NAC prior to curative treatments (surgery or definitive chemoradiation therapy: dCRT) was done in 115 cStage II/III ESCC patients with either CDDP/5-FU (CF) (n=41) or Docetaxel/CDDO/5-FU (DCF) NAC (n=74) between 2007 and 2013.
Results (1) Esophagectomy was finally done in 35 from the 41 CF NAC (85%), while in 48 from the 74 DCF NAC (66%). Preservation rate of the esophagus was more frequent in DCF NAC than in CF NAC (p=0.018). (2) Prognosis was better in DCF NAC than in CF NAC, where overall survival (OS) of DCF was 76.7% and that of CF was 52.1% (p=0.071), and progression free survival (PFS) of DCF was 58.3% and that of CF was 30.5% (p=0.0060). DCF NAC represents less events of progression than CF NAC (p=0.0040), largely due to excellent control of preoperative disease (p=0.018) and postoperative lymph node recurrence (p=0.014). (3) Adverse effects significantly more frequently seen in DCF NAC was leukopenia, neutropenia, febrile neutroopenia, hyponatremia, and anorexia than those in CF NAC.
Conclusion Potent DCF NAC in clinical Stage II/III ESCC could have a great potential for better prognosis due to suppression of specific progression events with higher preservation rate of the esophagus, while required careful monitoring of the serious adverse events.

キーワード

臓器別:食道

手法別:化学療法

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