Comparison of cisplatin and 5-fluorouracil chemotherapy protocols combined with concurrent radiotherapy for esophageal cancer

Purpose: The optimal chemotherapeutic protocol for the treatment of esophageal cancer has not yet been established. This study was performed to identify the differences in toxicity and completion rates of various chemotherapy protocols with that goal in mind. Materials and methods: A total of 61 patients with esophageal cancer were enrolled in this study between June 2002 and January 2004. The total radiotherapy dose was 64 Gy. Three chemotherapy protocols were used. Arm A comprised daily low-dose cisplatin (CDDP) and 5-fluorouracil (5FU) (CF protocol) (3 mg/m² and 180 mg/m², respectively). Arm B was intermediate between arm A and C (CDDP 7 mg/m ² and 5FU 250 mg/m² on days 1-5, 8-12, 29-33, and 36-40). Arm C comprised two courses of standard CF (CDDP 70 mg/m² on day 1 and 5FU 600 mg/m²/24 h on days 1-4). Results: Although there were no significant differences in hematological toxicity between the protocols, leukocytopenia was slightly milder in arm A. Nausea was significantly more severe in arm C. The completion rate was higher in arm A. The 3-year survival rates were 40%, 31%, and 62%, respectively. Conclusion: The daily low-dose CF protocol showed a trend of mild toxicity regarding leukocytopenia. However, we could not find statistical difference between arms. It also showed a better completion rate than the other two arms.