P-3905-fluorouracil and cisplatin regulated with leucovorin for locally advanced esophageal cancer

Introduction: This study was performed to examine the effectiveness and toxic side effects of the combination of cisplatin and 5-fluorouracil (5FU) with leucovorin (LV) in locally advanced esophageal cancer (LAEC) prior to surgery. Methods: The study included 30 male patients aged 40-70 years with locally advanced squamous cell carcinoma of the esophagus were treated with chemotherapy prior to local therapy from March 2012 to February 2016. The combination of chemotherapy was 5FU 750mg/m ² IV (days 1-5), cisplatin 20 mg/m² IV (days 1-5), LV 200mg/m ²(days 1-5). Repeated cycles were given every 28 days. A resectable surgical procedure or radiation therapy was performed after examination of patients after they had received 3 courses of this combination of chemotherapy. Results: CT scan and endoscopy was done prior to surgery to evaluate the overall response rate, which was found to be more than 50% (33% PR and 17% CR). WHO Grade III-IV toxicities occurred as follows: Grade III-IV diarrhoea in 4 patients, Grade III-IV vomiting in 5 patients, Grade III-IV mucositis in 3 patients. Surgery was done in 20 patients and radiotherapy was done in 9 patients and one patient with CR refused radiotherapy. Radical surgery was performed in 16 patients and palliative surgery in 4 patients. Three patients (CR) underwent surgery. Due to chronic lung disease, further patients were ineligible to surgery. One pathologic CR was found. The surgical mortality rate was 3/20. Eight out of 12 patients became tumour-free after surgery and were disease-free and alive 5 to 30 months after surgery with median of 10 months. Conclusion: This combination shows minimal and acceptable toxicity with remarkable anticancerous activity.