178. OUTCOME OF DOCETAXEL, CISPLATIN, AND 5-FLUOROURACIL COMBINATION CHEMORADIOTHERAPY FOR LOCALLY ADVANCED ESOPHAGEAL CANCER

Abstract

Abstract Background T4b esophageal cancer, chemoradiotherapy with 5FU plus cisplatin (FP-RT) is usually performed as a treatment option. However, its therapeutic efficacy has not been satisfactory, and there is still no certain opinion on its use, including induction therapy and surgical intervention. In recent years, favorable outcomes of radiation therapy with DCF (DCF-RT) have been reported, but there is no consensus. Therefore, we aimed to retrospectively analyze the outcomes of DCF-RT of our hospital. Methods We retrospectively analyzed the safety and efficacy of 61 patients treated with DCF-RT for cT4 esophageal cancer from March 2014 to December 2021. The regimens were (DTX: 30/m2 Day1, CDDP: 10 mg/m2 Day1–5, 5-FU: 400 mg/m2 Day1–5) 2 courses or (DTX: 35/m2 Day1, CDDP: 40 mg/m2 Day1, 5-FU: 400 mg/m2 Day1–5) 3 courses + RT (40-60Gy). Results The main location of tumor was Ce/Ut/Mt/Lt = 20/8/24/2 cases. Dose reduction was required in 19 cases (33%); CTCAE ver 4.0 Grade 3 or higher adverse events were leukopenia 53%, neutropenia 51%, febrile neutropenia 19%, anorexia 12%; no treatment-related deaths were observed. Clinical response was CR/PR/SD/PD = 3/42/9/3 patients, with a response rate of 79%. Clinically downstage from T4 was achieved in 42 patients (74%), and esophagectomy was performed in 51 patients (91%). 20 patients (38%) required combined resection of T4b organs and 48 patients (94%) achieved R0 resection. Pathological response was Grade 1/2/3/NA = 12/24/12/4, and overall survival (1Y/2Y/3Y) = 86/68/54% after CRT. In summary, DCF-RT for T4 esophageal cancer seemed to be relatively safe and may contribute to long survial.