Neoadjuvant chemotherapy in squamous cell carcinoma of the esophagus using low dose continuous infusion 5-fluorouracil and cisplatin: results of a prospective study.
Indian J Cancer
;
2004 Jan-Mar; 41(1): 3-7
Article
in English
| IMSEAR
| ID: sea-49962
ABSTRACT
BACKGROUND:
Surgery is the treatment of choice for localized esophageal squamous cell carcinoma (ESCC). Despite curative surgical resection, the majority of patients develop local and systemic recurrence with poor 5-year survival.AIMS:
To study the role of low dose continuous infusion (CI) 5-fluorouracil (5-FU) and cisplatin as neoadjuvant chemotherapy in ESCC. SETTINGS ANDDESIGN:
A non-randomized prospective study conducted over a period of two years (1996-1998) in the Department of Surgery, All India Institute of Medical Sciences, India. MATERIAL ANDMETHODS:
Twenty-two patients with ESCC were included in the study. Chemotherapy consisted of a continuous 30-day infusion of 5-FU (350 mg/m2/day) and cisplatin (7.5 mg/m2/day), 5 days/week for 4 weeks. All patients had surgery following chemotherapy.RESULTS:
A full course of chemotherapy was completed in 18 patients (82%). Chemotherapy was not completed due to non-compliance (n=2), thrombophlebitis (n=1), and vomiting (n=1). Grade-1 haematological and hepato-toxicity was observed in four patients. Thirteen patients developed thrombophlebitis. After chemotherapy, improvement in dysphagia was observed in 13 of 22 (59%) patients. Radiological partial response was observed in 8 patients (36.4%). 19 patients underwent surgical resection (86.4%) with zero mortality. Post-operative morbidity was observed in six patients (27%). Complete and partial pathological response was observed in two (11%) and one patient (5.5%) respectively. The overall median survival was 18 months and 4-year survival was 42%.CONCLUSIONS:
Low dose CI 5-FU and cisplatin is well tolerated with minimal toxicity. Histopathological response rates and survival figures are comparable with the more toxic neoadjuvant chemotherapeutic regimens.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Thrombophlebitis
/
Vomiting
/
Remission Induction
/
Aged
/
Female
/
Humans
/
Male
/
Esophageal Neoplasms
/
Carcinoma, Squamous Cell
/
Antineoplastic Combined Chemotherapy Protocols
Type of study:
Controlled clinical trial
/
Observational study
/
Prognostic study
/
Risk factors
Language:
English
Journal:
Indian J Cancer
Year:
2004
Type:
Article
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