Neoadjuvant Chemotherapy With Docetaxel Plus Cisplatin And Capecitabine/5-Fluorouracil For Locally Advanced Esophageal Squamous Cell Carcinoma

Abstract

Background: Optimal neoadjuvant chemotherapy (nCT) for esophageal squamous cell carcinoma (ESCC) is controversial. Moreover,
evidence of neoadjuvant therapies in real-world scenario is essential. This study was to assess short-term and oncological outcomes of
nCT with docetaxel plus cisplatin and capecitabine/5-fluorouracil (DCX/DCF) for locally advanced ESCC in Vietnamese population.
Methods: A retrospective study was conducted from July 2019 to December 2020 with 112 patients who completed a nCT regimen
with DCX (105 patients) or DCF (7 patients) for locally advanced ESCC. The patients then underwent a radical surgery or an adjuvant
radiation depending on clinical response. Short-term outcomes included clinical response based on the Response Evaluation Criteria in
Solid Tumor version 1.1 and adverse events assessed by the National Cancer Institute-Common Toxicity Criteria for Adverse Events.
Oncological outcomes were overall survival (OS) and disease-free survival (DFS).

Results: Mean age was 61.1 years and 111/112 patients were male. Most (65.2%) were in stage IVa before treatment. Adjuvant radiation
was performed in 24 patients (21.4%) and 69 (61.6%) underwent surgery. Complete response was achieved in 99 patients (88.4%), but
only 18/69 patients (26.1%) achieved pathological complete response. Severe adverse events (grade 3-4) were infrequently observed
with neutropenia (8%), anemia (3.6%), and leukopenia (2.7%). Two-year OS and DFS were 62% and 53% respectively. Patients with
complete response had significantly higher survival rate than those without complete response.
Conclusions: nCT with DCX/DCF regimen is safe and has a high rate of clinical complete response. However, patients with locally
advanced ESCC still have poor survival.