Preliminary Results of Definitive Concurrent Chemoradiation Therapy With S-1 and Nedaplatin for Locally Advanced Esophageal Squamous Cell Carcinoma

Abstract

This trial aimed to evaluate the efficiency and safety of S-1 and nedaplatin combined with definitive concurrent radiotherapy in locally advanced esophageal squamous cell carcinoma patients. We collected retrospectively the data of definitive CRT with nedaplatin and S-1.All of patients were pathologically proved locally advanced esophageal squamous cell carcinoma (T3-4N0M0 or anyTN+M0) in this study. patients received IMRT with a simultaneous integrated boost (SIB-IMRT) to primary tumor and involved lymph nodes(60.2Gy and 50.4Gy in 28 fractions).Nedaplatin 70 mg/m2 was given on days 1 and 22, and concurrent S-1 was administered twice daily at a dosage (50mg/m2/d) on days 1-14,every 3 weeks. Patients received two courses of concurrent chemoradiotherapy with or without two additional courses as adjuvant therapy every 4 weeks. From July 2013 to December 2015, 47 patients were included (27 with stage II, 20 with stage III, AJCC 7th). The median age was 61 years (range: 43-74 years), thirty-one (66 %) patients completed the prescribed full dose and concurrent two cycles. A complete response was achieved in 32 patients (68 %).With a median follow-up of 17 months (range 8-35), the actually 1-year overall survival (OS), locoregional recurrence free survival (LRFS) and distant-metastasis free survival (DMFS) in this study were 97.3%, 81.6% and 92.9%, respectively. Grade ≥3 leukopenia°×°û, thrombocytopeniaѪÐ″å, and anemiaƶѪ occurred in 8%, 14%, and 4 % of the patients, respectively.. The most common nonhematologic toxicity was esophagitis including 8 patients with grades. No patients experienced Grade 5 adverse events within the 30 days after chemoradiotherapy. S-1 plus Nedaplatin with concurrent IMRT was feasible and efficacious for locally advanced esophageal cancer patients. Toxicities were tolerable and clinically manageable. More prospective studies are warranted to clarify this issue.