Open AccessToxicity data for preoperative concurrent chemoradiotherapy with oxaliplatin and continuous infusion 5‐fluorouracil for locally advanced esophageal cancer
Author(s) -
Thukral A.,
Metz J.,
Hwang W.T.,
O'Dwyer P.,
Plastaras J.,
Both S.,
Ad V. Bar
Publication year - 2011
Publication title -
diseases of the esophagus
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 63
eISSN - 1442-2050
pISSN - 1120-8694
DOI - 10.1111/j.1442-2050.2010.01145.x
Subject(s) - medicine , mucositis , dysphagia , oxaliplatin , esophageal cancer , chemoradiotherapy , radiation therapy , nausea , tolerability , surgery , cancer , gastroenterology , colorectal cancer , adverse effect
SUMMARY The purpose of this retrospective analysis was to characterize the feasibility and tolerability of oxaliplatin/5‐fluorouracil (5‐FU) given concurrently with radiotherapy for patients with locally advanced esophageal cancer. Between July 2005 and March 2009, 15 patients with clinical stage T3/T4 and/or N1/M1a lower esophageal or gastroesophageal junction adenocarcinoma were treated with preoperative chemoradiotherapy using oxaliplatin every 2 weeks and continuous infusion 5‐FU. The main treatment‐related toxicities were oral mucositis and dysphagia. During the first 2 weeks of treatment, 20% of patients presented with grade 1–2 oral mucositis, and one patient developed grade 1 dysphagia. In weeks 3–4, 53% of the patients experienced grade 1–2 mucositis, and 40% experienced grade 1–2 dysphagia. One patient only experienced grade 3 mucositis in week 4. Three patients (20%) had grade 3–4 dysphagia in weeks 3–4 and were continued on intravenous fluids and pain medications. During the last 2 weeks of chemoradiotherapy, 53% of patients reported grade 1–2 oral mucositis, mostly grade 1 and 73% of patients experienced grade 1–2 dysphagia and 26% patients experienced grade 3–4 dysphagia. Other toxicities included fatigue, nausea, neuropathy, and diarrhea. Only one patient experienced > 10% weight loss. The whole group was treated with aggressive supportive care during radiotherapy. Five (33%) patients achieved a pathological complete response. No patients developed locoregional failure. Sixty percent of the patients developed distant metastases and the 2‐year disease‐free survival was 53%. The median survival was 3.2 years with the 2‐year overall survival of 73%. Preoperative oxaliplatin/5‐FU‐based chemoradiotherapy for locally advanced esophageal cancer is feasible, but associated with substantial gastrointestinal toxicity. A careful attention to nutrition and hydration throughout the course of therapy is required.