Triple induction chemotherapy and chemoradiotherapy for locally advanced esophageal cancer. A phase II study.

BACKGROUND This phase II trial assessed the feasibility and safety of induction chemotherapy with cisplatin (25 mg/m(2) d1-5, d29-34)/docetaxel (75 mg/m(2) d1, d29)/5-fluorouracil (5-FU, 750 mg/m(2) d1-5, d 29-34) followed by external beam radiotherapy concurrent with docetaxel (15 mg/m(2) d1,8,15,22) and 5-FU (300 mg/m(2) continuous infusion on the days of radiotherapy). PATIENTS AND METHODS Twenty-four patients with locally advanced carcinoma of the esophagus were included. Following chemotherapy and chemoradiation eligible patients underwent esophagectomy. If surgery could not be performed patients received definitive radiation. RESULTS Sixteen patients underwent resection. Pathologic complete remission was achieved in 5 of those 16 patients, 13 patients had downstaging of disease. R0 resection was feasible in all 16 patients. Main grade 3 and 4 toxicities were neutropenia in 10 patients, diarrhea in 4 and postoperative morbidity in 9 patients. At a median follow-up of 16.5 months 15 patients are alive; median survival has not yet been reached. CONCLUSION Neoadjuvant treatment with cisplatin/docetaxel/5-fluorouracil followed by chemoradiation with docetaxel/5-fluorouracil is safe, feasible, and effective.