823 induction chemotherapy with 2-weekly dcf regimen for squamous cell carcinoma of the esophagus

Abstract Tri or 4-weekly Decetaxel, Cisplatin and Fluorouracil (DCF) regimen for esophageal squamous cell carcinoma (ESCC) was reported to be highly effective as a neoadjuvant chemotherapy, however higher hematologic toxicity rate was problematic with this regimen. JCOG0807 study revealed 2-weekly DCF regimen was less toxic and effective for unresectable or metastatic ESCC, however its efficacy for resectable ESCC as an induction chemotherapy is unknown. Methods The aim of this study was to clarify the safety and efficacy of 2-weekly DCF regimen for resectable ESCC. We reviewed 94 pts with ESCC who received 2-weekly DCF regimen (30 mg/m2 docetaxel on days 1 and 15, 80 mg/m2 cisplatin on day 1, 800 mg/m2 fluorouracil on days 1–5, repeated every 3 weeks) between Apr. 2010 and Dec. 2019. Clinical stage II, III, IVA and IVB ESCC pts were included. Those with cT4b and cM1 other than No.104 nodes were excluded. The safety, efficacy and survival were retrospectively investigated. Results Fifty-eight pts were enrolled. Clinical stage was II in 6, III in 39, IVA in 6 and IVB in 7. Common grade 3/4 adverse events were neutropenia (19%), hyperglycemia (7%), and febrile neutropenia (3%). Treatment related death was occurred in one (2%) for neutropenia. The overall response rate (RR) was 50% and disease control rate was 93%. The R0 resection rate was 81% without in-hospital deaths. Grade 2/3 pathological RR was 38% and pCR rate was 7%. Median survival time (MST) was 84 mts and 5-yr OS was 59% with a median observational period of 37 mts. Conclusion The 2-weekly DCF regimen for resectable ESCC showed tolerable hematologic toxicity, relatively better efficacy and survival. This regimen can be an alternative choice as an induction chemotherapy for ESCC.