Concurrent chemoradiotherapy with S-1 and cisplatin in advanced esophageal cancer

S. H. Cho, H. J. Shim, Se Ryeon Lee, J. S. Ahn, D. H. Yang, Y. K. Kim, T. K. Nam, J. J. Lee, H. J. Kim, Ik Joo Chung

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Abstract

How best to manage advanced esophageal cancer remains unresolved, especially in palliative care. Here, in a pilot study, we evaluated the efficacy and safety of concurrent chemoradiotherapy with S-1 and cisplatin in advanced esophageal cancer. Patients with locally advanced or metastatic squamous cell carcinoma of the esophagus received S-1 and cisplatin at doses of 70 mg/m2/day for 14 days and 70 mg/m2 on day 1, respectively, every 3 weeks. Concurrently, radiotherapy was started at a dose of 200 cGy/day, up to a total of 5400 cGy. After concurrent chemoradiotherapy, additive chemotherapy was repeated up to six cycles. Thirty patients were enrolled in this study; of the 27 in whom efficacy could be evaluated, an objective response rate was seen in 20 (74.1%), including five (18.5%) complete pathologic responses in primary lesions. Improvement of dysphagia was seen in 21 (76%) patients. In patients with stage II or III esophageal cancer, the median progression-free survival and overall survival were 10.6 ± 0.6 months (95% CI: 9.4-11.8) and 23.0 ± 5.1 months (95% CI: 13.0-32.9), respectively. In patients with stage IV esophageal cancer, the median progression-free survival and overall survival were 5.4 ± 1.6 months (95% CI: 2.2-8.6) and 11.6 ± 1.6 months (95% CI: 8.4-14.8), respectively. The main hematological toxicity was neutropenia, but no neutropenic fever was observed. The major non-hematological toxicities were asthenia and vomiting, mostly of grades 1 and 2. Thus, concurrent chemoradiotherapy with S-1 and cisplatin may be a promising nonsurgical treatment in advanced esophageal cancer.

Original languageEnglish
Pages (from-to)697-703
Number of pages7
JournalDiseases of the Esophagus
Volume21
Issue number8
DOIs
Publication statusPublished - 2008 Nov 24
Externally publishedYes

Keywords

  • Chemoradiotherapy
  • Cisplatin
  • Esophageal cancer
  • S-1

ASJC Scopus subject areas

  • Gastroenterology

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    Cho, S. H., Shim, H. J., Lee, S. R., Ahn, J. S., Yang, D. H., Kim, Y. K., Nam, T. K., Lee, J. J., Kim, H. J., & Chung, I. J. (2008). Concurrent chemoradiotherapy with S-1 and cisplatin in advanced esophageal cancer. Diseases of the Esophagus, 21(8), 697-703. https://doi.org/10.1111/j.1442-2050.2008.00837.x