Open Access Highly Accessed Research article

Long-term bresults of radiotherapy combined with nedaplatin and 5-fluorouracil for postoperative loco-regional recurrent esophageal cancer: update on a phase II study

Keiichi Jingu1*, Haruo Matsushita1, Ken Takeda1, Rei Umezawa1, Chiaki Takahashi1, Toshiyuki Sugawara1, Masaki Kubozono1, Keiko Abe1, Takaya Tanabe1, Yuko Shirata1, Takaya Yamamoto1, Youjirou Ishikawa1 and Kenji Nemoto2

Author affiliations

1 Department of Radiation Oncology, Tohoku University School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan

2 Department of Radiation Oncology, Yamagata University School of Medicine, Yamagata, Japan

For all author emails, please log on.

Citation and License

BMC Cancer 2012, 12:542  doi:10.1186/1471-2407-12-542

Published: 22 November 2012

Abstract

Background

In 2006, we reported the effectiveness of chemoradiotherapy for postoperative recurrent esophageal cancer with a median observation period of 18 months. The purpose of the present study was to update the results of radiotherapy combined with nedaplatin and 5-fluorouracil (5-FU) for postoperative loco-regional recurrent esophageal cancer.

Methods

Between 2000 and 2004, we performed a phase II study on treatment of postoperative loco-regional recurrent esophageal cancer with radiotherapy (60 Gy/30 fractions/6 weeks) combined with chemotherapy consisting of two cycles of nedaplatin (70 mg/m2/2 h) and 5-FU (500 mg/m2/24 h for 5 days).

The primary endpoint was overall survival rate, and the secondary endpoints were progression-free survival rate, irradiated-field control rate and chronic toxicity.

Results

A total of 30 patients were enrolled in this study. The regimen was completed in 76.7% of the patients. The median observation period for survivors was 72.0 months. The 5-year overall survival rate was 27.0% with a median survival period of 21.0 months. The 5-year progression-free survival rate and irradiated-field control rate were 25.1% and 71.5%, respectively. Grade 3 or higher late toxicity was observed in only one patient. Two long-term survivors had gastric tube cancer more than 5 years after chemoradiotherapy.

Pretreatment performance status, pattern of recurrence (worse for patients with anastomotic recurrence) and number of recurrent lesions (worse for patients with multiple recurrent lesions) were statistically significant prognostic factors for overall survival.

Conclusions

Radiotherapy combined with nedaplatin and 5-FU is a safe and effective salvage treatment for postoperative loco-regional recurrent esophageal cancer. However, the prognosis of patients with multiple regional recurrence or anastomotic recurrence is very poor.

Keywords:
Postoperative recurrent esophageal cancer; Chemoradiotherapy; Long-term results; Phase II study