A RESECTED CASE OF ADVANCED ESOPHAGEAL CARCINOMA SHOWING A PROMINENT RESPONSE TO NEOADJUVANT CHEMOTHERAPY WITH 5-FU AND LEUCOVORIN

Abstract

A 62-year-old man with advanced esophageal carcinoma which was suspected of direct invasion into the left atrium and descending aorta was confirmed to have Botallo's lymph nodes metastasis (M0N3A3 in Stage IV). So it was judged that operation was impossible and radiation was started. Mediastinitis developed when total radiation amounted to 10.5 Gy. Radiation therapy was withdrawn. Neoadjuvant chemotherapy with sustained i. v. drip infusion of 5-FU was started, and on the way 3 courses of Leucovorin 9mg daily for continuous 5 days were added. Total doses of 5-FU and Leucovorin came to 31, 500mg and 144mg, respectively. With the neoadjuvant chemotherapy, the size of the tumor decreased prominently (Pl0M0N0A0, stage 0). After the esophageal resection with reconstruction, the lesion of carcinoma almost disappeared microscopically. Only 3 small cancer nests in the lamina propria were found. Unfortunately this patient died of cardiorespiratory distress. It is though that sustained i. v. drip infusion of a low dose of 5-FU with Leucovorin regimen is safe and a promising neoadjuvant chemotherapy.