Neoadjuvant chemotherapy (FAP) for advanced esophageal cancer.

This study was performed to assess the usefulness and safety of neoadjuvant chemotherapy utilizing the FAP regimen consisting of 5-fluorouracil, cisplatin and adriamycin for the treatment of highly advanced esophageal cancer. Twenty-seven patients with Stage III or more advanced esophageal cancer were enrolled in the study. The patients generally received two cycles of FAP. The response rate was as high as 55.6% and the resectability rate as high as 85.2%. All adverse events reported were mild in intensity. The histological effect was assessed as follows: Grade 1 in 18 patients, Grade 2 in 3 patients and Grade 3 (a pathological complete response) in 2 patients. All patients with nonresectable tumors died within 6 months, whereas of the 5 patients who responded with Grade 2 or better histological effects, all survived without recurrence for a follow-up period up to 60 months. The results of this study therefore showed the usefulness and safety of FAP therapy, which is considered to be a treatment method worth aggressively trying for highly advanced esophageal cancer in which a curative resection can hardly be expected.