Second-line combination chemotherapy with docetaxel for cisplatin-pretreated refractory metastatic esophageal cancer: A preliminary report of initial experience

Background and Aims: Patients with esophageal cancer often develop metastatic disease after esophageal resection and generally receive cisplatin-based chemotherapy or chemoradiotherapy. The efficacy and toxicity of the combination of docetaxel, 5-fluorouracil (5-FU) and cisplatin (DFC) as a second-line chemotherapy were evaluated in patients with postoperative metastatic esophageal cancer refractory to cisplatin-based chemotherapy. Patients and Methods: Twenty patients with metastatic esophageal cancer after esophagectomy refractory to cispatin-based therapy were included in this study. The DFC regimen consisted of docetaxel (60 mg/m(2)) on day 1, 5- FU (500 mg/day) on days 1-5 and cisplatin (10 mg/day) on days 1 - 5, being repeated every 3 weeks. Results: A total of 49 cycles (median 2, range 1 - 6) was administered to 20 patients. The median follow-up was 8 months (range 3 - 24). Of the 20 patients, 1 had a complete response, 6 had a partial response, 6 had stable and 7 had progressive disease. Median time to progression for all pa-tients was 4 months (95% Cl 1.7 - 5.6). The median overall survival for all patients was 8 months ( 95% Cl 5.7 - 10.3). The major toxicity was myelosuppression. Neutropenia of grade 3 or more occurred in 13 patients ( 65%), and thrombocytopenia of grade 3 occurred in 1 patient ( 5%). Febrile neuropenia was observed in 1 patient ( 5%). There was no treatment-related mortality. Conclusion: DFC is a feasible and promising regimen as a second-line therapy in metastatic/ recurrent esophageal cancer refractory to cisplatin- based chemotherapy.