Feasibility of definitive chemoradiation therapy with nedaplatin and 5-fluorouracil in elderly patients with esophageal squamous cell carcinoma: A retrospective study

Akinori Watanabe, MD; Chikatoshi Katada, MD, PhD; Shouko Komori, MD; Hiromitsu Moriya, MD, PhD; Keishi Yamashita, MD, PhD; Hiroki Harada, MD; Mizutomo Azuma, MD, PhD; Yuki Kondo, MD; Yo Kubota, MD; Yasuaki Furue, MD; Natsuko Kawanishi, MD; Sakiko Yamane, MD; Takuya Wada, MD; Takafumi Yano, MD; Kenji Ishido, MD, PhD; Satoshi Tanabe, MD, PhD; Kazushige Hayakawa, MD, PhD; Wasaburo Koizumi, MD, PhD

Advances in Radiation Oncology (Jul 2018)

Feasibility of definitive chemoradiation therapy with nedaplatin and 5-fluorouracil in elderly patients with esophageal squamous cell carcinoma: A retrospective study

Akinori Watanabe, MD,
Chikatoshi Katada, MD, PhD,
Shouko Komori, MD,
Hiromitsu Moriya, MD, PhD,
Keishi Yamashita, MD, PhD,
Hiroki Harada, MD,
Mizutomo Azuma, MD, PhD,
Yuki Kondo, MD,
Yo Kubota, MD,
Yasuaki Furue, MD,
Natsuko Kawanishi, MD,
Sakiko Yamane, MD,
Takuya Wada, MD,
Takafumi Yano, MD,
Kenji Ishido, MD, PhD,
Satoshi Tanabe, MD, PhD,
Kazushige Hayakawa, MD, PhD,
Wasaburo Koizumi, MD, PhD

Affiliations

Akinori Watanabe, MD: Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan
Chikatoshi Katada, MD, PhD: Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan; Corresponding author. Department of Gastroenterology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan.
Shouko Komori, MD: Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, Sagamihara, Japan
Hiromitsu Moriya, MD, PhD: Department of Gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Japan
Keishi Yamashita, MD, PhD: Department of Gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Japan
Hiroki Harada, MD: Department of Gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Japan
Mizutomo Azuma, MD, PhD: Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan
Yuki Kondo, MD: Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan
Yo Kubota, MD: Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan
Yasuaki Furue, MD: Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan
Natsuko Kawanishi, MD: Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan
Sakiko Yamane, MD: Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan
Takuya Wada, MD: Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan
Takafumi Yano, MD: Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan
Kenji Ishido, MD, PhD: Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan
Satoshi Tanabe, MD, PhD: Research and Development Center for New Frontier, Kitasato University School of Medicine, Sagamihara, Japan
Kazushige Hayakawa, MD, PhD: Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, Sagamihara, Japan
Wasaburo Koizumi, MD, PhD: Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan

Journal volume & issue: Vol. 3, no. 3
pp. 305 – 313

Abstract

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Purpose: This study was designed to retrospectively analyze the safety and efficacy of chemoradiation therapy with nedaplatin and 5-fluorouracil in elderly patients with esophageal squamous cell carcinoma. Methods and materials: Eligible patients were aged 76 years or older, had a histopathologic diagnosis of esophageal squamous cell carcinoma, and were treated at the Kitasato University Hospital between January 2010 and March 2016. Chemotherapy consisted of nedaplatin in an intravenous dose of 90 mg/m2 on day 1 and 5-fluorouracil in an intravenous dose of 800 mg/m2 on days 1 to 5, repeated every 4 weeks for 2 cycles. Radiation therapy consisted of 50.4 Gy in 28 fractions for thoracic tumors and 61.2 Gy for cervical tumors. Results: Twenty-five patients were studied. Patient characteristics were as follows: median age 79 years (range, 76-85 years), clinical stage I/II/III/IV (7/8/8/2, respectively), and surgically resectable/unresectable (17/8, respectively). The completion rates of radiation therapy and chemoradiation therapy were 100% and 84%, respectively. Grade ≥3 acute toxicities included neutropenia (76%), leukopenia (72%), thrombocytopenia (32%), anemia (28%), anorexia (32%), oral mucositis (20%), febrile neutropenia (12%), and esophagitis (8%). Grade ≥3 late toxicities included esophageal stenosis (12%) and pleural effusion (4%). The complete response rate was 64%. In the median follow-up period of 18.9 months, the 1-year overall survival rate was 68%. Conclusions: Definitive chemoradiation therapy with nedaplatin and 5-fluorouracil may be a feasible treatment option for elderly patients with esophageal squamous cell carcinoma.

Published in Advances in Radiation Oncology

ISSN: 2452-1094 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine; Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: http://www.journals.elsevier.com/advances-in-radiation-oncology/

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