| Concurrent FP (5-fluorouracil, cisplatin) Chemoradiotherapy for Patients with Esophageal Cancer |
| Min Ok Kim, Eui Sil Hong, Ji Young Chai, Joung Muk Leem, Il Young You, Won Dong Kim, Woo Yoon Park, Seung Taik Kim, Ki Hyeong Lee |
1Department of Internal Medicine, Chungbuk NationalUniversity College of Medicine, Cheongju, Korea.kihlee@chungbuk.ac.kr
2Department of Radiation Oncology, Chungbuk NationalUniversity College of Medicine, Cheongju, Korea.
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Published online: August 31, 2003. |
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| ABSTRACT |
PURPOSE:
The outcomes of a surgical approach for patients with an esophageal carcinoma remain unsatisfactory despite its high complication rates. We conducted a phase II trial, using combined FP (5-fluorouracil and cisplatin) chemotherapy and concurrent radiotherapy, as a definitive therapy for patients with esophageal cancer.
MATERIALS AND METHODS:
Patients with histologically proven esophageal cancer were enrolled onto this study. The treatment consisted of four courses of chemotherapy and six and a half weeks of radiotherapy. The patients received chemotherapy in weeks 1, 5, 12 and 16 (5-fluorouracil 1, 000 mg/m2 on days 1 to 4 and cisplatin 75 mg/m2 on day 1).
Radiotherapy was administered at a dose of 59.4 Gy, in five 1.8 Gy fractions a week.
RESULTS:
A total of 22 eligible patients entered the study.
Of the 19 evaluable patients, a complete response occurred in 7 (37%), and a partial response in 8 (42%). After a median follow-up of 35 months, the overall survival rate was 32% at three years and the median survival was 11 months.
Fourteen (64%) received planned dose of radio-therapy and 13 (59%) received more than three courses of chemotherapy.
However, there was no difference in three-year survival rates between the patients that received less than three courses of chemotherapy and those that received three or more courses (31% vs. 32%). The major treatment related toxicity was mucositis, which developed in every patient, with grades III or IV in thirteen (59%) patients. During the treatment, the patients lost, on average, 3.8% of their body weight. The mean hospital stay was 23 days, with a total duration of treatment of 74 days.
CONCLUSIONS:
Concurrent FP chemoradiotherapy was effective as a definitive therapy for patients with esophageal cancer.
The major toxicity was mucositis. Although the treatment was relatively feasible, a randomized trial of reduced courses of chemotherapy is warranted. |
| Key words:
Esophageal neoplasm;Concurrent chemoradiotherapy |
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