Feasibility assessment of global standard chemoradiotherapy followed by surgery in patients with esophageal cancer

Liang,Yao; Maeda,Osamu; Miyata,Kazushi; Kanda,Mitsuro; Shimizu,Dai; Sugita,Shizuki; Okada,Tohru; Ito,Junji; Kawamura,Mariko; Ishihara,Shunichi; Nakatochi,Masahiro; Ando,Masahiko; Kodera,Yasuhiro; Ando,Yuichi

doi:10.3892/mco.2023.2630

Feasibility assessment of global standard chemoradiotherapy followed by surgery in patients with esophageal cancer

Authors:
- Yao Liang
- Osamu Maeda
- Kazushi Miyata
- Mitsuro Kanda
- Dai Shimizu
- Shizuki Sugita
- Tohru Okada
- Junji Ito
- Mariko Kawamura
- Shunichi Ishihara
- Masahiro Nakatochi
- Masahiko Ando
- Yasuhiro Kodera
- Yuichi Ando
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Affiliations: Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Aichi 466-8560, Japan, Division of Surgical Oncology, Department of Surgery, Nagoya, Aichi 466-8550, Japan, Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan, Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan, Public Health Informatics Unit, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Aichi 461-8673, Japan, Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Aichi 466-8560, Japan
Published online on: March 2, 2023 https://doi.org/10.3892/mco.2023.2630
Article Number: 34
Copyright: © Liang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The present study aimed to assess the feasibility of global standard chemoradiotherapy (CRT) followed by surgery in patients with esophageal cancer. A prospective study was conducted at Nagoya University Hospital (Nagoya, Japan) to evaluate global standard CRT followed by surgery in patients with esophageal cancer. The CRT regimen consisted of 75 mg/m² cisplatin on day 1 and 1,000 mg/m² fluorouracil daily on days 1‑4 given twice 4 weeks apart together with concurrent esophageal irradiation starting on day 1 (group A). For comparison, 17 patients with esophageal cancer who had received the same chemotherapy regimen but with lower drug doses were retrospectively reviewed: 70 mg/m² cisplatin on day 1 and 700 mg/m² fluorouracil daily on days 1‑4 given twice 4 weeks apart together with concurrent esophageal irradiation starting on day 1 (group B). Grade 3 or worse adverse events were observed in 9 of the 12 patients (75%) in group A and in 5 of the 17 patients (29%) in group B. The patients in group A were more likely to experience grade 3 or worse neutropenia (50%) than those in group B (6%). No febrile neutropenia or treatment‑related deaths occurred in either group. A total of 11 patients (92%) in group A and 16 patients (94%) in group B subsequently underwent an esophagectomy, and 9 (82%) and 14 (88%) of these patients, respectively, achieved microscopically margin‑negative resection (R0 resection). In conclusion, global standard CRT was more likely to cause severe but manageable adverse events. There was no apparent difference in the R0 resection rate or postoperative complications between the two treatments. This clinical trial was registered at the Japan Registry of Clinical Trials (trial registration number: jRCT1041180004) on September 11, 2018.

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