First-line cisplatin plus bolus 5- Fluorouracil combination in patients with locally advanced and metastatic esophageal cancer(Izmir Oncology Group Study)

OBJECTIVE: Cytotoxic chemotherapy is the basic treatment for locally advanced and metastatic esophageal cancer. We evaluated the benefits and side effects of the first-line short-term infusional 5- Fluorouracil (5-FU) and cisplatin combination regimen in patients with locally advanced and metastatic esophageal squamous cell cancer.
METHODS: We retrospectively reviwed the untreated locally advanced or metastatic squamous cell esophageal cancer patients treated with short-term infusional 5-FU and cisplatin combination between December 2006 and july 2013. Chemotherapy regimen was administered as; cisplatin 75 mg/m2 on day 1 (1-3-h infusion), ca-leucovorin 60 mg/m2 d1-2 and 5-FU 500 mg/m2 d1-2 (15-min infusion) every 14 days.
RESULTS: There were 14 (51.9%) male and 13 (48.1%) female patients. The median age was 57 (range, 39-80) years. Twenty patients had an Eastern Cooperative Oncology Group performance status of 0 to 1 (77%), while the rest had PS of 2 (23%). At first diagnosis, 10 patients had distant metastases and 17 patients had localized disease. In total, 27 patients were treated with a median of four cycles. The overall response rate was 44.4% (8 partial responses, 4 complete responses) and 7 patients (25.9%) had stable disease. The disease control rate was 70.3%. Median progression free survival was 6.2 (95% CI: 5.13 7.28) months and median overall survival was 11.1 (95% CI: 7.77-14.5) months. Among the patients, 40.7% of them had grade 3-4 neutropenia, 11.1% of those patients had grade 3-4 thrombocytopenia.
CONCLUSION: Short-term infusional 5-FU and cisplatin combination regimen can be considered as an alternative treatment to an infusion regimen in which a catheter is necessary for the drug infusion.

Lokal ileri ve metastatik özefagus kanserli hastalarda ilk hat bolus 5-Fluorourasil sisplatin kombinasyonu(Ýzmir Onkoloji Grubu Çalýþmasý)

AMAÇ: Sitotoksik kemoterapi, lokal ileri ve metastatik özefagus kanserinin standart tedavisidir. Biz bu çalýþmada lokal ileri ve metastatik özefagus skuamoz hücreli kanserde birinci basamakta sisplatin ve kýsa süreli infüzyonel 5-florourasil (5-FU) kombinasyonunun yararlarýný ve yan etkilerini deðerlendirdik.
YÖNTEMLER: Bu çalýþmada, retrospektif olarak aralýk 2006 ve temmuz 2013 tarihleri arasýnda sisplatin ve kýsa süreli infüzyonel 5-florourasil (5-FU) kombinasyonu ile tedavi edilen daha önceden tedavi almamýþ lokal ileri veya metastatik özefagus skuamoz hücreli kanserli hastalarý deðerlendirdik. Kemoterapi rejimi olarak sisplatin 75 mg/m2 d1 (1-3-saat infuzyon), kalsiyum lökoverin 60 mg/m2 d1-2 ve 5-FU 500 mg/m2 d1-2 (15-dakika infuzyon) 14 günde bir uygulandý.
BULGULAR: Hastalarýn 14’ü (%51.9) erkek ve 13’ü (%48.1) kadýn olup ortanca yaþ 57 (39-80) idi. ECOG performans skoru 20 (%77) hastada 0 veya 1 iken diðer hastalarda 2 olarak bulundu. Taný anýnda 10 hasta uzak metastaza sahipken 17 hasta lokal ileri hastalýða sahipti. Hastalar medyan 4 kür kemoterapi aldý. Tüm yanýt oraný %44.4’tü. (8 hastada parsiyel yanýt,4 hasta komplet yanýt) ve 7 (%25.9) hasta stabil hastalýða sahipti. Hastalýk kontrol oraný %70.3’tü. Hastalarýn medyan progresyonsuz saðkalýmý 6.2 (%95 CI: 5.13 7.28) ve medyan genel saðkalýmý 11.1 (%95 CI: 7.77-14.5) aydý. Hastalarýn % 40.7’sinde grade 3-4 nötropeni ve % 11.1’inde grade 3-4 trombositopeni saptandý.
SONUÇ: Sisplatin ve kýsa süreli infüzyonel 5-florourasil (5-FU) kombinasyonu ilaç infuzyonu için kateter gerektiren infüzyonel rejime alternative bir tedavi olarak düþünülebilir.