ĐÁNH GIÁ ĐÁP ỨNG ĐIỀU TRỊ DẪN ĐẦU MODIFIED-DCF KẾT HỢP HÓA XẠ TRỊ TRIỆT CĂN TRONG UNG THƯ THỰC QUẢN GIAI ĐOẠN T3-T4B/ N1-2/ M0 TẠI BỆNH VIỆN ĐẠI HỌC Y HÀ NỘI

Abstract

Introduction: Esophageal cancer (ESCC) is often diagnosed at advanced stages, with chemoradiotherapy serving as the primary treatment modality. The modified docetaxel, cisplatin, and fluorouracil (m-DCF) regimen is introduced with chemoradiotherapy to augment disease control. This study aimed to evaluate the efficacy and safety of induction m-DCF followed by definitive chemoradiotherapy in patients with T3-T4b/N1-2/M0 ESCC at Hanoi Medical University Hospital. Methods: This descriptive case series included patients with unresectable ESCC stages T3-T4b/N1-2/M0. Patients received 4-6 cycles of induction m-DCF (docetaxel 40 mg/m², cisplatin 40 mg/m², leucovorin 400 mg/m², fluorouracil 2400 mg/m² administered every two weeks) followed by concurrent chemoradiation 50.4 Gy with a paclitaxel-carboplatin regimen. Results: From January 2020 to June 2024, 43 eligible patients were enrolled. T4 tumors constituted 51.16% of cases, and N2 lymph node involvement 61.47%. Mean age was 61.0 ± 9.2. The overall response rate (ORR) was 95.4%, with a complete clinical response observed in 23.3% of patients. A mean depth of tumor regression after chemoradiation was 67.14% ± 22.4, correlating with the regression achieved after induction chemotherapy. The most common grade 3 toxicity was neutropenia (25.6%), with no grade 4 toxicities. Other adverse events were infrequent and manageable. Conclusion: modified-DCF combined with definitive chemoradiotherapy represents a safe, well-tolerated, and effective regimen for disease control in patients with locally advanced ESCC.