In this Japanese study of people with the squamous type of oesophageal cancer (the type that is common in Asia), three-drug chemotherapy before surgery (adding docetaxel to cisplatin and fluorouracil) raised the chance of being alive after 3 years from about 63% to 72%. Adding radiotherapy to two-drug chemotherapy did not give a meaningful benefit. The three-drug regimen had more side effects, such as fever with a low white blood cell count, and is suitable for patients in good general health.
Resectable locally advanced squamous cell carcinoma, age 20–75 years, ECOG PS 0–1
| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Docetaxel | 70 mg/m² | IV | Day 1 |
| Cisplatin | 70 mg/m² | IV | Day 1 |
| Fluorouracil | 750 mg/m²/day | IV | Days 1–5 |
Doses from the JCOG1109 trial. Grade 3 or higher febrile neutropenia occurred in 16% of patients, and 9% discontinued treatment because of adverse events.
On the page “Oesophageal cancer” · Locally advanced disease: treatment with curative intent
Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.
Two cycles of fluorouracil 800 mg/m² per day IV on days 1 to 5 and cisplatin 80 mg/m² on day 1, 3 weeks apart; followed by oesophagectomy with regional lymph node dissection.
Three cycles of fluorouracil 750 mg/m² per day on days 1 to 5, cisplatin 70 mg/m² and docetaxel 70 mg/m² on day 1, every 3 weeks; followed by surgery.
Two cycles of fluorouracil 1000 mg/m² per day on days 1 to 4 and cisplatin 75 mg/m² on day 1, 4 weeks apart, with radiotherapy 41.4 Gy; followed by surgery.
Source of the regimen details: Doses taken from the abstract of the published paper (Lancet 2024).
Doses are given for the information of specialists, as in this study’s protocol, and are not a prescription. Every drug must be prescribed by the treating physician for the individual patient.
Patients aged 20 to 75 years with previously untreated locally advanced squamous cell carcinoma of the oesophagus, with ECOG performance status 0 or 1.
Primary endpoint: overall survival (intention-to-treat analysis). Other endpoints: safety and surgical complications.
Grade 3 or higher febrile neutropenia occurred in 1% (NeoCF), 16% (NeoCF+D) and 5% (NeoCF+RT). Discontinuation of neoadjuvant treatment due to adverse events was more common in the triplet group (9% versus 6% and 4%). Treatment-related deaths during the neoadjuvant period were 2%, 2% and 1%.
This trial made neoadjuvant triplet DCF the proposed standard option for locally advanced oesophageal squamous cell carcinoma in suitable patients in Japan (according to the authors themselves). Its use in non-Asian populations and its comparison with the CROSS regimen have not yet been studied directly.
Only Japanese patients up to 75 years of age with good performance status were enrolled; the trial was open-label; the radiotherapy regimen and its accompanying chemotherapy differ from the CROSS regimen; most patients were men.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.
Who are you reading this site as?
Your choice applies to every page; change it any time from the bottom of the page.
Type to search...