COMPARISON OF LONG-TERM RESULTS BETWEEN DEFINITIVE CHEMORADIOTHERAPY CONCURRENT WITH FOLFOX VERSUS CF IN PATIENTS WITH INOPERABLE EASOPHAGEAL CANCER AT K HOSPITAL AND THANH HOA ONCOLOGY HOSPITAL

Nguyễn Quang Hưng1,, Nguyễn Tuyết Mai2, Võ Văn Xuân2, Nguyễn Thị Thu Hường3, Nguyễn Thị Tố Quyên1
1 Thanh Hoa Oncology Hospital
2 Vietnam National Cancer Hospital
3 Hanoi Medical University

Main Article Content

Abstract

Objectives: To evaluate the results of treatment of inoperable stage esophageal cancer with chemoradiotherapy concurrently with the FOLFOX regimen; toxicity and side effects of the regimen. Subjects and methods: Prospective intervention study, with a control group on 102 patients with non-operative esophageal cancer who received chemoradiotherapy concurrently and divided into 2 groups: study group treated with FOLFOX regimen and control group treated with CF regimen combined with radiation dose of 50Gy/5 weeks, divided dose of 2Gy/day. Results: The rate of complete and partial response in the study group was 27.5% and 64.6%, 25.5% and 60.8% higher than that of the control group; p = 0.78. The rate of complete response according to disease stage II, III in the study group and control group was 33.3%, 23.3% and 33.3%, 20.0%, respectively; p > 0.05. Overall survival rate of 12 months, 18 months and 24 months in the study group was 90.1%, 64.7% and 45.1%; in the control group were 84.3%, 54.9% and 39.2%; p = 0.56. The overall median survivalwas 19.9 ± 0.81 months compared with 18.4 ± 0.79 in the control group, p = 0.67; Meanprogression-free survival (PFS)was 18.5± 0.89 months compared with 17.2± 0.90 in the control group, p = 0.59. Some factors affecting treatment outcome are tumor size, disease stage, treatment interruption and treatment response. Toxicity (hematology, liver, kidney, other organs) is mostly grade I, II. Conclusion: The FOLFOX regimen compared with the CF regimen showed similar efficacy in response rate, overall survival as well as progression-free survival and was somewhat superior in the group of late stage patients; At the same time, the FOLFOX regimen had little effect on the general condition, renal function and significantly less nausea, vomiting, and hair loss than the CF regimen. The FOLFOX regimen should be widely used in the treatment of inoperable esophageal cancer stage and should be considered the first choice.

Article Details

References

1. Sung H, Ferlay J và cộng sự. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA CANCER J CLIN. 2021;(71):209–249.
2. NCCN. Esophageal and Esophagogastric Junction cancers. NCCN Guidelines version 2.2022. 2022.
3. Bùi Quang Huy. Đánh giá kết quả xạ trị điều biến liều thể tích hình cung (VMAT) kết hợp hóa trị trong ung thư thực quản 1/3 giữa dưới giai đoạn cT3,4N0-2M0. Đại học Y Hà Nội; 2020.
4. Conroy T và cộng sự. Definitive chemoradiotherapy with FOLFOX versus fluorouracil and cisplatin in patients with oesophageal cancer (PRODIGE5/ACCORD17): final results of a randomised, phase 2/3 trial. Lancet Oncol 2014;15:305-314.
5. Nguyễn Đức Lợi. Đánh giá hiệu quả phác đồ hoá xạ trị đồng thời và một số yếu tố tiên lượng ung thư biểu mô thực quản giai đoạn III,IV tại Bệnh viện K. Trường Đại học Y Hà Nội; 2015.
6. Hàn Thị Thanh Bình. Nhận xét đặc điểm lâm sàng, mô bệnh học và kết quả điều trị ung thư biểu mô thực quản tại Bệnh viện K giai đoạn 1998-2004. Đại Học Y Hà Nội; 2004.
7. Honing J và cộng sự. A comparison of carboplatin and paclitaxel with cisplatinum and 5-fluorouracil in definitive chemoradiation in esophageal cancer patients. Ann Oncol. 2014;25(3):638.
8. Zhang P và cộng sự. Concurrent cisplatin and 5-fluorouracil versus concurrent cisplatin and docetaxel with radiotherapy for esophageal squamous cell carcinoma: a propensity score-matched analysis. Oncotarget. 2016;7(28).