Study of neoadjuvant chemoradiotherapy with combined S-1 and low-dose cisplatin for patients with clinical stage II/III esophageal cancer

Abstract

Background: Trimodality therapy with surgery and neoadjuvant chemoradiotherapy (nCRT) has been developed to improve survival outcomes in advanced esophageal cancer. We hypothesized that the effect of surgery plus nCRT with oral fluoropyrimidine (S-1) and low-dose cisplatin will be effective with low toxic effects in patients with esophageal cancer as well as gastric cancer. Methods: This cohort study included 28 Japanese patients who underwent nCRT plus esophagectomy for esophageal cancer in preoperative clinical Stage II/III. They received only one cycle of S-1 and low-dose cisplatin concurrently, followed by surgery 3–4 weeks after completion of nCRT (the doses of radiotherapy were 20 or 30 Gy). We examined the clinical efficacy and safety of nCRT plus esophagectomy. Results: All patients had squamous cell carcinoma and they all completed nCRT and underwent esophagectomy. No treatment-related deaths were observed. The response rate to nCRT was 92.9%. The 1-year, 3-year, and 5-year overall survival rates were 84.4%, 67.0%, and 67.0%, respectively for Stage II/III. Conclusion: Toxicity of nCRT was acceptable, and the efficacy and prognosis were favorable, particularly as we performed only one cycle of neoadjuvant chemotherapy with low doses of radiotherapy.

Keywords

• esophageal cancer
• low-dose cisplatin
• neoadjuvant chemoradiotherapy
• S-1