PS02.099: EFFORTS IN PROPHYLAXIS OF FEBRILE NEUTROPENIA IN DCF THERAPY FOR ESOPHAGEAL CANCER

Abstract

Abstract Background DCF therapy (5-FU + CDDP + Docetaxel) for esophageal cancer is known to have strong anti-tumor effect but the incidence of bone marrow suppression (BMS) and febrile neutropenia (FN) after DCF therapy has been frequent and patients is often forced to reduce the dose of anti-cancer drug or discontinue of chemotherapy. We clarified the influence of prophylactic administration of a long-acting G-CSF, pegfilgrastim, in DCF therapy for esophageal cancer on the incidence of adverse events and anti-tumor effect. Methods From March, 2011 to July, 2017, 87 patients underwent DCF therapy (Docetaxel 60mg/m2 D1, CDDP 60mg/m2 D1, 5-FU 800mg/m2 D1–5) for esophageal squamous cell carcinoma above cStage II (33 patients administered pegfilgrastim, P group; 54 patients without pegfilgrastim, N group). We investigated the influence of pegfilgrastim on the incidence of adverse events in both groups according to CTCAE v4.0 grading system. And we investigated anti-tumor effects assessed by image examination in all patients and 47 surgically resected specimens. Results The incidence of leukocytopenia and neutropenia in P group were significantly lower than that in N group (15.2% vs 57.4%, P < 0.001; 21.2% vs 64.8%, P < 0.001, respectively). The incidence of FN in P group tended to be lower than that in N group (9.1% vs 20.4%, P = 0.233). Significantly more patients in N group suffered dose reduction or discontinuation of chemotherapy due to BMS or FN (30.3% vs 72.2%, P < 0.001). Relative dose intensity of 5-FU in P group was significantly higher than that in N group (95.6% vs 82.5%, P = < 0.001). In endoscopically evaluated response after 2 courses of DCF therapy, the reductive effects in the patients in P group significantly better than in those in N group (PR < ; 78.1% vs 44.0%, P = 0.002). The overall response rate was also significantly better in the patients in P group than in those in N group (PR < ; 60.6% vs 35.2%, P = 0.021). Histopathological responses in surgically resected tumor in P group tended to be better than N group (Grade 1b < ; 47.1% vs 33.3%, P = 0.352). Conclusion DCF chemotherapy with prophylactic administration of pegfilgrastim may be an option for safe and effective chemotherapy for advanced esophageal cancer. Disclosure All authors have declared no conflicts of interest.