Abstract
Since 2019, the FOLFOX (5-FU, l-leucovorin, and oxaliplatin) regimen has been available for esophageal squamous cell carcinoma (ESCC) treatment in Japan; however, clinical information from Japan regarding the regimen is limited. This study was designed as a single institute, retrospective chart review. We reviewed 252 EC patients (pts) between January 2015 and June 2020. The inclusion criteria were as follows: a diagnosis of ESCC, a performance Status (PS) of 0-2 and treatment using the FOLFOX regimen, because MDT/MDC judged cisplatin unfit ( PS2, age (≥75 years), low renal function (CCr <30), or cisplatin hypersensitivity). The Institutional Review Board approved this study (No.2020-054). 12 pts met the inclusion criteria (7 people were FOLFOX alone and 5 people were chemoradiotherapy (CRT)). The median age was 76 years (range, 62-81 years). The performance status (ECOG) was 1 in 8 pts and 2 in 4 pts. There were 1, 2, and 9 pts in the IIIC, IVA, IVB clinical stages, respectively. 5 pts were treated with CRT with 50.4 Gy/28 Fr. The median number of cycles was 8 (4-10) in the FOLFOX group and 6 (1-15) in the CRT group. The median progression free survival and overall response rate in FOLFOX alone and CRT group were 5 months (95% CI, 2.1-NA) vs. 7.5 months (95% CI, 6-NA) and 42% vs. 80% respectively. 1 pt (14%) achieved complete response (CR) and 2 pts (28%) achieved partial response (PR) in the FOLFOX group. 2 pts (20%) achieved CR and 2 pts (20%) achieved PR in the CRT group. 4 pts (80%) in the CRT group completed CRT therapy, and two in four pts were almost in outpatient treatment. Grade 3 or higher adverse events were neutropenia (n=3), thrombocytopenia (n=4), anemia (n=1), abnormal liver function (n=1), and mucositis (n=1). Treatment discontinuation due to regimen-related toxicity was not seen. Our case series demonstrated the feasibility of FOLFOX-based treatment for Japanese pts with LA or metastatic ESCC.
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