DOI QR코드

DOI QR Code

Clinical Study on Lobaplatin Combined with 5-Fu and Concurrent Radiotherapy in Treating Patients with Inoperable Esophageal Cancer

  • Jia, Xiao-Jing (Department of Tumor Radiationtherapy, the Second Hospital of Jilin University) ;
  • Huang, Jing-Zi (Department of Radiationtherapy, General Hospital of Jilin Chemical Group Company)
  • Published : 2015.10.06

Abstract

Objective: To investigate short- and long-term treatment effects and side reactions of lobaplatin plus 5-Fu combined and concurrent radiotherapy in treating patients with inoperable middle-advanced stage esophageal cancer. Methods: Sixty patients with middle-advanced stage esophageal squamous cell cancer were retrospectively analyzed. All patients were administered lobaplatin (50 mg intravenously) for 2 h on day 1, and 5-Fu ($500mg/m^2$) injected intravenously from day 1 to 5 for 1 cycle, in an interval of 21 days for totally 4 cycles. At the same time, late-course accelerated hyperfractionated three-dimensional conformal radiotherapy was performed. Patients were firstly treated with conventional fractionated irradiation (1.8 Gy/d, 5 times/week, a total of 23 treatments, and DT41.4 Gy), and then treated with accelerated hyperfractionated irradiation (1.5 Gy, 2 times/d, a total of 27 Gy in 9 days, an entire course of 6-7 weeks, and DT 68.4Gy). Results: All patients completed treatment, including 10 complete response (CR), 41 partial response (PR), 7 stable disease (SD), and 2 progressive disease (PD). The total effective rate was 85.0% (51/60). Thirty-nine patients had an increased KPS score. One-, 2-, and 3-year survival rates were 85.3%, 57.5%, and 41.7%, respectively. The median survival time was 27 months. The adverse reactions included myelosuppression, which was mainly degree I and II. The occurrence rate of radiation esophagitis was 17.5%. No significant hepatic or renal toxicity was observed. Conclusion: Lobaplatin plus 5-Fu combined with concurrent radiotherapy is safe and effective in treating patients with middle-advanced stage esophageal cancer. However, this result warrants further evaluation by randomized clinical studies.

Keywords

Lobaplatin;5-Fu;concurrent radiochemotherapy;esophageal cancer

References

  1. American Joint Committee on Cancer. AJCC Cancer Staging Hand book. 6th ed. Philadelphia: Lippincott-Raven, 2002.
  2. Brenner B, Ilson DH, Minsky BD (2004). Treatment of localized esophageal cancer. Semin Oncol, 31, 554-65. https://doi.org/10.1053/j.seminoncol.2004.04.015
  3. Chinese Society of Esophagenal Cancer, Chinese Anti-Cancer Association (2011). Clinical Practice Guidelines for the Diagnosis and Treatment of Esophageal Cancer [M] Beijing: China Union Medical University Press, 116-9.
  4. Li X, Zhou F, Ren Z, et al (2007). Phase Ⅱ trail of Lobaplatin, leucovorin and fluorouracil in patient s with advanced carcinoma of the esophagus. Chin J Cancer Prev Treat, 14, 65-7.
  5. Lin Y, Chen J, Li J, et al (2012). Recent results of concurrent chemoradiotherapy with lobaplatin and paclitaxel in advanced esophageal carcinoma. Cancer Res Clinic, 24, 105-7.
  6. Mckeage MJ (2001). Lobaplatin: a new antitumour platinum drug. Expert Opin Investig Drugs, 10, 119-28. https://doi.org/10.1517/13543784.10.1.119
  7. Mei, J, Liu J, Yao W (2002). Concurrent chemoradiotherapy for locoregional esophageal cancer. Chin J Clin Oncol Rehab, 9, 98-9.
  8. Polee MB, Tilanus HW, Eskens FA (2003). Phase II study of neo-adjuvant chemotherapy with paclitaxel and cisplatin given every 2 weeks for patients with a resectable squamous cell carcinoma of the esophagus. Ann Oncol, 14, 1253-7. https://doi.org/10.1093/annonc/mdg328
  9. Schmoll HJ, Kohne CH, Papagerorion E, et al (1995). Single angent lobaplatin is active in patients with esophageal squamous cell carcinoma: a phase II evaluation. Proc Am Soc Clin Oncol, 14, 483.
  10. Sun Y, Zhou J (2003). Manual of Medical Oncology [M] 4th edition. Beijing: People's Medical Publishing House, 2003: 106-107, 274-276.
  11. Urba SG, Orringer MB, Ianettonni M, et al (2003). Concurrent cisplatin, paclitaxel, and radiotherapy as preoperative treatment for patients with locoregional esophageal carcinoma. Cancer, 98, 2177-83. https://doi.org/10.1002/cncr.11759
  12. Ye H (2002). Combined chemoradiotherapy in the in the treatment of middle-advanced stage esophageal cancers. Cancer Res Clinic, 14, 187-8.
  13. Zhao KI, Shi XH, Jiang GL, et al (2005). Late course accelerated hyperfractionated radiotherapy plus concurrent chemotherapy for squamous cell carcinoma of the esophagus: a phase III randomized study. Int J Radiat Oncol Biol Phys, 62, 1014-20. https://doi.org/10.1016/j.ijrobp.2004.12.022