ACCELERATED HYPERFRACTIONATED RADIATION-THERAPY AND CONCURRENT 5-FLUOROURACIL CISPLATIN CHEMOTHERAPY FOR LOCOREGIONAL SQUAMOUS-CELL CARCINOMA OF THE THORACIC ESOPHAGUS - A PHASE-II STUDY/

Purpose: To improve the poor prognosis of patients with locoregional e sophageal squamous cell cancer, we used concurrent accelerated hyperfr actionated radiation therapy (ACC HFX RT) and chemotherapy (CHT). Mate rial and Methods: Between January 1988 and June 1993, 28 patients were treated with ACC HFX RT with 1.5 Gy twice daily, to a total dose of 5 4 Gy concurrently with 5-fluorouracil (5-FU) (300 mg/m(2), days 1-5) a nd cisplatin (CDDP) (10 mg/m(2), days 1-5), both given during weeks 1 and 3 of the ACC HFX RT course. Following the ACC HFX RT/CHT, two addi tional courses of 5-FU (500 mg/m(2), days 1-5) and CDDP (20 mg/m(2), d ays 1-5) were both given during weeks 7 and 10. The median age and Eas tern Cooperative Oncology Group performance status were 62 and 1, resp ectively. The American Joint Committee on Cancer (AJCC) stage was I in 12 patients, II in 10, and III in 6. Results: The median survival tim e was 26 months, and the 5-year survival rate was 29%. The rates at 5 years for freedom from relapse, locoregional recurrence, and distant m etastasis were 29%, 61%, and 45%, respectively. Univariate analysis re vealed that performance status, stage, weight loss, tumor length, and tumor location influenced survival, while age and sex did not. The mos t frequent acute high-grade (3 or 1) toxicities were esophagitis and l eukopenia, seen in 50% and 39% of patients, respectively. Late high-gr ade toxicity was infrequent. There were no treatment-related deaths. C onclusion: The results of this study compare favorably with those of p revious studies, albeit of relatively high incidence of acute high-gra de toxicity. Further studies are warranted to compare its efficacy wit h other approaches. (C) 1998 Elsevier Science Inc.