Phase II study of chemoselection with docetaxel plus cisplatin and 5-fluorouracil induction chemotherapy and subsequent conversion surgery for locally advanced unresectable oesophageal cancer

Tomoya Yokota, Ken Kato, Yasuo Hamamoto, Yasuhiro Tsubosa, Hirofumi Ogawa, Yoshinori Ito, Hiroki Hara, Takashi Ura, Takashi Kojima, Keisho Chin, Shuichi Hironaka, Takayuki Kii, Yasushi Kojima, Yasunori Akutsu, Hisayuki Matsushita, Kentaro Kawakami, Keita Mori, Yushi Nagai, Chika Asami, Yuukou Kitagawa

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Abstract

Background:The standard treatment for locally advanced unresectable squamous cell carcinoma (SCC) of the oesophagus is chemoradiation with cisplatin and 5-fluorouracil (CF-RT). This multicentre phase II trial assessed the safety and efficacy of chemoselection with docetaxel plus cisplatin and 5-fluorouracil (DCF) induction chemotherapy (ICT) and subsequent conversion surgery (CS) for initially unresectable locally advanced SCC of the oesophagus.Methods:Patients with clinical T4 and/or unresectable supraclavicular lymph node metastasis were eligible. Treatment started with three cycles of DCF-ICT, followed by CS if resectable, or by CF-RT if unresectable. The resectability was re-evaluated at 30-40 Gy of CF-RT, followed by CS if resectable, or by completion of 60 Gy of CF-RT. If resectable after CF-RT, CS was performed. The primary end point was 1-year overall survival (OS).Results:From April 2013 to July 2014, 48 patients were enrolled. CS was performed in 41.7% (n=20), including DCF-CS (n=18), DCF-CF-RT40Gy-CS (n=1), and DCF-CF-RT60Gy-CS (n=1). R0 resection was confirmed in 19 patients (39.6%). Grade ≥3 postoperative complications included one event each of recurrent laryngeal nerve palsy, lung infection, wound infection, pulmonary fistula, and dysphagia; but no serious postoperative complications were observed in patients undergoing CS. Clinical complete response after CF-RT was confirmed in 4 patients (8.3%). The estimated 1-year OS was 67.9% and lower limit of 80% confidence interval was 59.7%. There was one treatment-related death in patient receiving DCF-CF-RT60Gy.Conclusions:Chemoselection with DCF-ICT followed by CS as a multidisciplinary treatment strategy showed promising signs of tolerability and efficacy in patients with locally advanced unresectable SCC of the oesophagus.

Original languageEnglish
Pages (from-to)1328-1334
Number of pages7
JournalBritish Journal of Cancer
Volume115
Issue number11
DOIs
Publication statusPublished - 2016 Nov 22

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docetaxel
Induction Chemotherapy
Esophageal Neoplasms
Fluorouracil
Cisplatin
Esophagus
Squamous Cell Carcinoma
Vocal Cord Paralysis
Lung
Survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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Phase II study of chemoselection with docetaxel plus cisplatin and 5-fluorouracil induction chemotherapy and subsequent conversion surgery for locally advanced unresectable oesophageal cancer. / Yokota, Tomoya; Kato, Ken; Hamamoto, Yasuo; Tsubosa, Yasuhiro; Ogawa, Hirofumi; Ito, Yoshinori; Hara, Hiroki; Ura, Takashi; Kojima, Takashi; Chin, Keisho; Hironaka, Shuichi; Kii, Takayuki; Kojima, Yasushi; Akutsu, Yasunori; Matsushita, Hisayuki; Kawakami, Kentaro; Mori, Keita; Nagai, Yushi; Asami, Chika; Kitagawa, Yuukou.

In: British Journal of Cancer, Vol. 115, No. 11, 22.11.2016, p. 1328-1334.

Research output: Contribution to journalArticle

Yokota, T, Kato, K, Hamamoto, Y, Tsubosa, Y, Ogawa, H, Ito, Y, Hara, H, Ura, T, Kojima, T, Chin, K, Hironaka, S, Kii, T, Kojima, Y, Akutsu, Y, Matsushita, H, Kawakami, K, Mori, K, Nagai, Y, Asami, C & Kitagawa, Y 2016, 'Phase II study of chemoselection with docetaxel plus cisplatin and 5-fluorouracil induction chemotherapy and subsequent conversion surgery for locally advanced unresectable oesophageal cancer', British Journal of Cancer, vol. 115, no. 11, pp. 1328-1334. https://doi.org/10.1038/bjc.2016.350
Yokota, Tomoya ; Kato, Ken ; Hamamoto, Yasuo ; Tsubosa, Yasuhiro ; Ogawa, Hirofumi ; Ito, Yoshinori ; Hara, Hiroki ; Ura, Takashi ; Kojima, Takashi ; Chin, Keisho ; Hironaka, Shuichi ; Kii, Takayuki ; Kojima, Yasushi ; Akutsu, Yasunori ; Matsushita, Hisayuki ; Kawakami, Kentaro ; Mori, Keita ; Nagai, Yushi ; Asami, Chika ; Kitagawa, Yuukou. / Phase II study of chemoselection with docetaxel plus cisplatin and 5-fluorouracil induction chemotherapy and subsequent conversion surgery for locally advanced unresectable oesophageal cancer. In: British Journal of Cancer. 2016 ; Vol. 115, No. 11. pp. 1328-1334.
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abstract = "Background:The standard treatment for locally advanced unresectable squamous cell carcinoma (SCC) of the oesophagus is chemoradiation with cisplatin and 5-fluorouracil (CF-RT). This multicentre phase II trial assessed the safety and efficacy of chemoselection with docetaxel plus cisplatin and 5-fluorouracil (DCF) induction chemotherapy (ICT) and subsequent conversion surgery (CS) for initially unresectable locally advanced SCC of the oesophagus.Methods:Patients with clinical T4 and/or unresectable supraclavicular lymph node metastasis were eligible. Treatment started with three cycles of DCF-ICT, followed by CS if resectable, or by CF-RT if unresectable. The resectability was re-evaluated at 30-40 Gy of CF-RT, followed by CS if resectable, or by completion of 60 Gy of CF-RT. If resectable after CF-RT, CS was performed. The primary end point was 1-year overall survival (OS).Results:From April 2013 to July 2014, 48 patients were enrolled. CS was performed in 41.7{\%} (n=20), including DCF-CS (n=18), DCF-CF-RT40Gy-CS (n=1), and DCF-CF-RT60Gy-CS (n=1). R0 resection was confirmed in 19 patients (39.6{\%}). Grade ≥3 postoperative complications included one event each of recurrent laryngeal nerve palsy, lung infection, wound infection, pulmonary fistula, and dysphagia; but no serious postoperative complications were observed in patients undergoing CS. Clinical complete response after CF-RT was confirmed in 4 patients (8.3{\%}). The estimated 1-year OS was 67.9{\%} and lower limit of 80{\%} confidence interval was 59.7{\%}. There was one treatment-related death in patient receiving DCF-CF-RT60Gy.Conclusions:Chemoselection with DCF-ICT followed by CS as a multidisciplinary treatment strategy showed promising signs of tolerability and efficacy in patients with locally advanced unresectable SCC of the oesophagus.",
author = "Tomoya Yokota and Ken Kato and Yasuo Hamamoto and Yasuhiro Tsubosa and Hirofumi Ogawa and Yoshinori Ito and Hiroki Hara and Takashi Ura and Takashi Kojima and Keisho Chin and Shuichi Hironaka and Takayuki Kii and Yasushi Kojima and Yasunori Akutsu and Hisayuki Matsushita and Kentaro Kawakami and Keita Mori and Yushi Nagai and Chika Asami and Yuukou Kitagawa",
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T1 - Phase II study of chemoselection with docetaxel plus cisplatin and 5-fluorouracil induction chemotherapy and subsequent conversion surgery for locally advanced unresectable oesophageal cancer

AU - Yokota, Tomoya

AU - Kato, Ken

AU - Hamamoto, Yasuo

AU - Tsubosa, Yasuhiro

AU - Ogawa, Hirofumi

AU - Ito, Yoshinori

AU - Hara, Hiroki

AU - Ura, Takashi

AU - Kojima, Takashi

AU - Chin, Keisho

AU - Hironaka, Shuichi

AU - Kii, Takayuki

AU - Kojima, Yasushi

AU - Akutsu, Yasunori

AU - Matsushita, Hisayuki

AU - Kawakami, Kentaro

AU - Mori, Keita

AU - Nagai, Yushi

AU - Asami, Chika

AU - Kitagawa, Yuukou

PY - 2016/11/22

Y1 - 2016/11/22

N2 - Background:The standard treatment for locally advanced unresectable squamous cell carcinoma (SCC) of the oesophagus is chemoradiation with cisplatin and 5-fluorouracil (CF-RT). This multicentre phase II trial assessed the safety and efficacy of chemoselection with docetaxel plus cisplatin and 5-fluorouracil (DCF) induction chemotherapy (ICT) and subsequent conversion surgery (CS) for initially unresectable locally advanced SCC of the oesophagus.Methods:Patients with clinical T4 and/or unresectable supraclavicular lymph node metastasis were eligible. Treatment started with three cycles of DCF-ICT, followed by CS if resectable, or by CF-RT if unresectable. The resectability was re-evaluated at 30-40 Gy of CF-RT, followed by CS if resectable, or by completion of 60 Gy of CF-RT. If resectable after CF-RT, CS was performed. The primary end point was 1-year overall survival (OS).Results:From April 2013 to July 2014, 48 patients were enrolled. CS was performed in 41.7% (n=20), including DCF-CS (n=18), DCF-CF-RT40Gy-CS (n=1), and DCF-CF-RT60Gy-CS (n=1). R0 resection was confirmed in 19 patients (39.6%). Grade ≥3 postoperative complications included one event each of recurrent laryngeal nerve palsy, lung infection, wound infection, pulmonary fistula, and dysphagia; but no serious postoperative complications were observed in patients undergoing CS. Clinical complete response after CF-RT was confirmed in 4 patients (8.3%). The estimated 1-year OS was 67.9% and lower limit of 80% confidence interval was 59.7%. There was one treatment-related death in patient receiving DCF-CF-RT60Gy.Conclusions:Chemoselection with DCF-ICT followed by CS as a multidisciplinary treatment strategy showed promising signs of tolerability and efficacy in patients with locally advanced unresectable SCC of the oesophagus.

AB - Background:The standard treatment for locally advanced unresectable squamous cell carcinoma (SCC) of the oesophagus is chemoradiation with cisplatin and 5-fluorouracil (CF-RT). This multicentre phase II trial assessed the safety and efficacy of chemoselection with docetaxel plus cisplatin and 5-fluorouracil (DCF) induction chemotherapy (ICT) and subsequent conversion surgery (CS) for initially unresectable locally advanced SCC of the oesophagus.Methods:Patients with clinical T4 and/or unresectable supraclavicular lymph node metastasis were eligible. Treatment started with three cycles of DCF-ICT, followed by CS if resectable, or by CF-RT if unresectable. The resectability was re-evaluated at 30-40 Gy of CF-RT, followed by CS if resectable, or by completion of 60 Gy of CF-RT. If resectable after CF-RT, CS was performed. The primary end point was 1-year overall survival (OS).Results:From April 2013 to July 2014, 48 patients were enrolled. CS was performed in 41.7% (n=20), including DCF-CS (n=18), DCF-CF-RT40Gy-CS (n=1), and DCF-CF-RT60Gy-CS (n=1). R0 resection was confirmed in 19 patients (39.6%). Grade ≥3 postoperative complications included one event each of recurrent laryngeal nerve palsy, lung infection, wound infection, pulmonary fistula, and dysphagia; but no serious postoperative complications were observed in patients undergoing CS. Clinical complete response after CF-RT was confirmed in 4 patients (8.3%). The estimated 1-year OS was 67.9% and lower limit of 80% confidence interval was 59.7%. There was one treatment-related death in patient receiving DCF-CF-RT60Gy.Conclusions:Chemoselection with DCF-ICT followed by CS as a multidisciplinary treatment strategy showed promising signs of tolerability and efficacy in patients with locally advanced unresectable SCC of the oesophagus.

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