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

 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 
Journal Title
Issue Date
Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Chemoradiotherapy ; Cisplatin/administration & dosage ; Disease-Free Survival ; Drug Combinations ; Esophageal Neoplasms/drug therapy* ; Esophageal Neoplasms/pathology ; Esophageal Neoplasms/radiotherapy* ; Esophageal Neoplasms/surgery ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Oxonic Acid/administration & dosage ; Prospective Studies ; Tegafur/administration & dosage
S-1 ; Cisplatin ; Esophageal cancer ; Chemoradiotherapy ; Preoperative
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.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae Joon(김대준)
Kim, Joo Hang(김주항)
Kim, Choong Bai(김충배)
Kim, Hyoung Il(김형일) ORCID logo https://orcid.org/0000-0002-6134-4523
Kim, Hye Ryun(김혜련) ORCID logo https://orcid.org/0000-0002-1842-9070
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Bae, Mi Kyung(배미경)
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Lee, Jin Gu(이진구)
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
Lee, Chang Young(이창영)
Lee, Hyuk(이혁)
Cho, Byoung Chul(조병철) ORCID logo https://orcid.org/0000-0002-5562-270X
Cha, Ji Hye(차지혜)
Hur, Jin(허진) ORCID logo https://orcid.org/0000-0002-8651-6571
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