Keijiro Sugimura1, Makoto Yamasaki2, Takushi Yasuda3, Masahiko Yano1, Motohiro Hirao4, Kazumasa Fujitani5, Yutaka Kimura3, Hiroshi Miyata1, Masaaki Motoori5, Atsushi Takeno6, Osamu Shiraishi3, Tomoki Makino2, Takayuki Kii7, Koji Tanaka2, Taro Satoh8, Masaki Mori9, Yuichiro Doki2. 1. Department of Surgery Osaka International Cancer Institute Osaka Japan. 2. Departments of Gastroenterological Surgery Graduate School of Medicine Osaka University Suita Japan. 3. Department of Surgery Kinki University Faculty of Medicine Osaka Sayama Osaka Japan. 4. Department of Surgery National Hospital Organization Osaka National Hospital Osaka Japan. 5. Department of Surgery Osaka General Medical Center Osaka Japan. 6. Department of Surgery Kansai Rosai Hospital Hyogo Japan. 7. Cancer Chemotherapy Center Osaka Medical College Hospital Osaka Japan. 8. Department of Frontier Science for Cancer and Chemotherapy Osaka University Graduate School of Medicine Suita Japan. 9. Department of Surgery and Science Graduate School of Medical Sciences Kyusyu University Fukuoka Japan.
Abstract
AIM: The aim is to report the long-term outcomes of preoperative cisplatin and fluorouracil plus docetaxel (DCF) vs Adriamycin (ACF) for resectable esophageal squamous cell carcinoma (ESCC). Previously, this trial showed that DCF is associated with prolonged recurrence-free survival (RFS). METHODS: Patients were randomly assigned to two cycles of ACF (35 mg/m2 of Adriamycin, 70 mg/m2 of cisplatin intravenously on day 1, and 700 mg/m2 of fluorouracil infusion for 7 days) every 4 weeks or DCF (70 mg/m2 of docetaxel, 70 mg/m2 of cisplatin intravenously on day 1, and 700 mg/m2 of fluorouracil infusion for 5 days) every 3 weeks, followed by surgery. The primary endpoint was RFS. The secondary endpoint was overall survival (OS). RESULTS: Between October 2011 and October 2013, 162 patients at 10 institutions were enrolled in the study, 162 of whom were eligible and randomly assigned to the two groups. The median follow-up for surviving patients was 69.8 months. The 5-year RFS was significantly better in the DCF group than in the ACF group (59.9% vs 40.7%, hazard ratio [HR] 0.55; 95% confidence interval [CI], 0.35-0.86; P = .009) and the 5-year OS was significantly better in the DCF group than in the ACF group (63.5% vs 49.4%, HR, 0.61; 95% CI, 0.38-0.96; P = .03). The benefit of DCF chemotherapy on survival was significantly greater in the subgroups with more advanced clinical T and N stage. CONCLUSIONS: Cisplatin and fluorouracil plus docetaxel are associated with better RFS and OS than ACF in resectable ESCC patients.
AIM: The aim is to report the long-term outcomes of preoperative cisplatin and fluorouracil plus docetaxel (DCF) vs Adriamycin (ACF) for resectable esophageal squamous cell carcinoma (ESCC). Previously, this trial showed that DCF is associated with prolonged recurrence-free survival (RFS). METHODS: Patients were randomly assigned to two cycles of ACF (35 mg/m2 of Adriamycin, 70 mg/m2 of cisplatin intravenously on day 1, and 700 mg/m2 of fluorouracil infusion for 7 days) every 4 weeks or DCF (70 mg/m2 of docetaxel, 70 mg/m2 of cisplatin intravenously on day 1, and 700 mg/m2 of fluorouracil infusion for 5 days) every 3 weeks, followed by surgery. The primary endpoint was RFS. The secondary endpoint was overall survival (OS). RESULTS: Between October 2011 and October 2013, 162 patients at 10 institutions were enrolled in the study, 162 of whom were eligible and randomly assigned to the two groups. The median follow-up for surviving patients was 69.8 months. The 5-year RFS was significantly better in the DCF group than in the ACF group (59.9% vs 40.7%, hazard ratio [HR] 0.55; 95% confidence interval [CI], 0.35-0.86; P = .009) and the 5-year OS was significantly better in the DCF group than in the ACF group (63.5% vs 49.4%, HR, 0.61; 95% CI, 0.38-0.96; P = .03). The benefit of DCF chemotherapy on survival was significantly greater in the subgroups with more advanced clinical T and N stage. CONCLUSIONS: Cisplatin and fluorouracil plus docetaxel are associated with better RFS and OS than ACF in resectable ESCC patients.
Authors: D P Kelsen; B Minsky; M Smith; J Beitler; D Niedzwiecki; D Chapman; M Bains; M Burt; R Heelan; B Hilaris Journal: J Clin Oncol Date: 1990-08 Impact factor: 44.544
Authors: Sandro Pasquali; Guang Yim; Ravinder S Vohra; Simone Mocellin; Donald Nyanhongo; Paul Marriott; Ju Ian Geh; Ewen A Griffiths Journal: Ann Surg Date: 2017-03 Impact factor: 12.969
Authors: M Yamasaki; T Yasuda; M Yano; M Hirao; K Kobayashi; K Fujitani; S Tamura; Y Kimura; H Miyata; M Motoori; O Shiraishi; T Makino; T Satoh; M Mori; Y Doki Journal: Ann Oncol Date: 2017-01-01 Impact factor: 32.976