5-Fluorouracil plus L-leucovorin and oxaliplatin treatment for esophageal squamous cell carcinoma: A multicenter retrospective study

Background Cisplatin-based chemotherapy is the standard treatment for advanced esophageal squamous cell carcinoma (ESCC). However, the 5-fluorouracil plus L-leucovorin and oxaliplatin (FOLFOX) regimen is available in Japan as an alternative to cisplatin-based chemotherapy, but its efficacy and safety remain unclear. Hence, we aimed to retrospectively evaluate patients with advanced ESCC who received FOLFOX therapy. Methods Patients with advanced ESCC who received FOLFOX therapy at 18 institutions between April 2019 and October 2020 were included. Fifty-two patients were received first-line FOLFOX treatment, while 39 patients received later-line FOLFOX treatment. Results The median progression-free survival, median overall survival, and objective response rate were 3.8 months (95% confidence interval [CI]: 3.0–5.0), 13.9 months (95% CI: 10.3–17.9 months), and 35% in the first-line group and 2.4 months (95% CI: 2.1–3.8 months), 7.2 months (95% CI: 5.3–9.8 months), and 4% in the later-line group, respectively. The most frequent grade 3 or 4 adverse events were neutropenia (23%) and anemia (12%) in the first-line group and neutropenia (18%), anorexia (13%), anemia (10%), and nausea (10%) in the later-line group. Conclusion First-line FOLFOX treatment is suitable for patients with advanced ESCC. However, FOLFOX has shown limited efficacy as a later-line treatment.