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Prospective study of definitive chemoradiotherapy with S-1 and nedaplatin in patients with stage II/III (non-T4) esophageal cancer

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Abstract

Background

Standard chemoradiotherapy (CRT) using 5-FU and CDDP is the optimal treatment for patients with stage II/III (non-T4) esophageal carcinoma. However, patient quality of life (QOL) cannot necessarily be maintained during this therapy, because 5-FU must be continuously infused for 24 h and CDDP administration requires a large transfusion volume. Therefore, hospitalization is unavoidable. We conducted a study of definitive CRT with S-1 and nedaplatin.

Methods

The study was conducted between July 2004 and December 2006. Eligibility criteria were stage II/III (non-T4), PS 0–2, age 20–79 years, and adequate organ function. S-1 80 mg/m2 was given on days 1–14, and nedaplatin 90 mg/m2 on day 1 every 4 weeks. Patients received two courses with concurrent radiotherapy of more than 50 Gy.

Results

Twenty patients (age range, 50–75 years; PS 0/1, 8/12; stage IIA/IIB/III, 11/2/7) were enrolled. Grade 4 leukopenia, thrombocytopenia, and anemia occurred in 15%, 10%, and 5% of patients, respectively. Grade 3 nonhematotoxicity included esophagitis in 3 patients (15%) and anorexia in 2 (10%). One patient developed febrile neutropenia; another developed an esophageal fistula. Complete response was achieved in 80%. The 3-year overall survival rate was 58.0%. Thirteen subjects received treatment as outpatients.

Conclusions

S-1 and nedaplatin in combination with radiotherapy is feasible, and toxicity is tolerable. This treatment method has the potential to shorten hospitalization and maintain patient QOL without impairing the efficacy of CRT.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan

    Takashi Tsuda, Naoki Izawa, Mami Hirakawa, Yoshiyuki Watanabe, Satoshi Kitajima & Fumio Itoh

  2. Department of Internal Medicine, General Sagami Kosei Hospital, Sagamihara, Kanagawa, Japan

    Hiroyuki Inaba & Aya Miyazaki

  3. Department of Radiology, Shonantobu General Hospital, Kamakura, Kanagawa, Japan

    Yoshikazu Hoshikawa

  4. Department of Radiology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan

    Hiromichi Gomi

  5. Department of Surgery, St. Joseph’s Hospital, Yokosuka, Kanagawa, Japan

    Masayuki Kimura

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  1. Takashi Tsuda
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  2. Hiroyuki Inaba
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  3. Aya Miyazaki
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  4. Naoki Izawa
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  6. Yoshiyuki Watanabe
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  7. Satoshi Kitajima
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  8. Yoshikazu Hoshikawa
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  9. Hiromichi Gomi
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  10. Masayuki Kimura
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  11. Fumio Itoh
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Correspondence to Takashi Tsuda.

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Tsuda, T., Inaba, H., Miyazaki, A. et al. Prospective study of definitive chemoradiotherapy with S-1 and nedaplatin in patients with stage II/III (non-T4) esophageal cancer. Esophagus 8, 45–51 (2011). https://doi.org/10.1007/s10388-011-0261-0

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  • DOI: https://doi.org/10.1007/s10388-011-0261-0

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