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A prospective phase II trial of s-1 and cisplatin-based chemoradiotherapy for locoregionally advanced esophageal cancer

Authors
 Hyun Chang  ;  Sung Kwan Shin  ;  Byoung Chul Cho  ;  Chang-Geol Lee  ;  Choong Bai Kim  ;  Dae Joon Kim  ;  Jin Gu Lee  ;  Jin Hur  ;  Chang Young Lee  ;  Mi Kyung Bae  ;  Hye Ryun Kim  ;  Sang Kil Lee  ;  Jun Chul Park  ;  Hyuk Lee  ;  Hyoung-Il Kim  ;  Hyunsoo Chung  ;  Jihye Cha  ;  Yong Chan Lee  ;  Joo-Hang Kim 
Citation
 Cancer Chemotherapy and Pharmacology, Vol.73(4) : 665-671, 2014 
Journal Title
 Cancer Chemotherapy and Pharmacology 
ISSN
 0344-5704 
Issue Date
2014
Abstract
PURPOSE: S-1 is a novel oral fluoropyrimidine anticancer agent designed to enhance clinical efficacy, reduce gastrointestinal toxicity, and enhance radiotherapy effectiveness. A phase II trial was conducted to evaluate the efficacy and safety of preoperative chemoradiation with S-1 and cisplatin in locoregionally advanced esophageal cancer. METHODS: Eligible patients had stage IIA-IVA esophageal cancer. Patients received two cycles of S-1 (days 1-14 and days 22-35) and cisplatin (days 1 and 22) with concurrent radiotherapy (50.4 Gy total; 1.8 Gy/fraction). Esophagectomy was performed between weeks 12 and 18 as determined by the specialist multidisciplinary team. RESULTS: Sixty patients were enrolled in this study between March 2008 and August 2011, and 59 were eligible. The clinical stage was ≥T3 in 28 patients (47 %) and N1 in 43 patients (72 %), with squamous cell carcinoma histology in 58 patients (97 %). Fifty-four patients (90 %) completed the planned chemoradiation. After chemoradiation, the clinical tumor response rate was 64.4 %. The primary toxicities included neutropenia (24 %) and esophagitis (8.5 %). Three treatment-related deaths were noted. Twenty-five patients (42 %) underwent esophagectomy following chemoradiation, and 15 achieved complete pathologic regression. The estimated overall survival and progression-free survival rates after 2 years were 65 and 48 %, respectively. CONCLUSIONS: Concurrent chemoradiation with S-1 and cisplatin exhibited encouraging results with complete pathologic regression. The survival data were promising compared with the historical data of 5FU/cisplatin and should be confirmed in a randomized phase III trial. Toxicities were significant but clinically manageable.
Full Text
http://link.springer.com/article/10.1007%2Fs00280-013-2371-y
DOI
10.1007/s00280-013-2371-y
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
김대준(Kim, Dae Joon)
김주항(Kim, Joo Hang)
김충배(Kim, Choong Bai)
김형일(Kim, Hyoung Il) ORCID logo https://orcid.org/0000-0002-6134-4523
김혜련(Kim, Hye Ryun) ORCID logo https://orcid.org/0000-0002-1842-9070
박준철(Park, Jun Chul) ORCID logo https://orcid.org/0000-0001-8018-0010
배미경(Bae, Mi Kyung)
신성관(Shin, Sung Kwan)
이상길(Lee, Sang Kil) ORCID logo https://orcid.org/0000-0002-0721-0364
이용찬(Lee, Yong Chan)
이진구(Lee, Jin Gu)
이창걸(Lee, Chang Geol) ORCID logo https://orcid.org/0000-0002-8702-881X
이창영(Lee, Chang Young)
이혁(Lee, Hyuk)
조병철(Cho, Byoung Chul)
차지혜(Cha, Ji Hye)
허진(Hur, Jin) ORCID logo https://orcid.org/0000-0002-8651-6571
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98361
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