Doxorubicin,cisplatin, and fluorouracil combination therapy for metastatic esophageal squamous cell carcinoma

The chemotherapy regimen currently used for treating esophageal and gastric carcinoma has been either epirubicin, cisplatin, and fluorouracil (5‐FU) or docetaxel, cisplatin, and 5‐FU. Here, we report the efficacy and toxicity of doxorubicin, cisplatin, and 5‐FU for only esophageal squamous cell carcinoma (ESCC). Between January 2000 and October 2008, a total of 41 ESCC patients with a distant metastasis were enrolled. The most common sites of metastasis were liver (26, 63.4%), lung (9, 22.0%), and bone (8, 19.5%). Doxorubicin was administered on day 1 at 30 mg/m², cisplatin on days 1–5 at 14 mg/m²/day, and 5‐FU on days 1–5 at 700 mg/m²/day. The median number of cycles was 2.0 (range 1‐8). The dose intensities of doxorubicin, cisplatin, and 5‐FU were 92.9, 92.4, and 92.5%, respectively. The overall response rate was 43.9%; one showed complete response, 17 showed partial response, 13 showed a stable disease, and 10 showed progressive disease (PD). The median survival time was 306 days (95% CI = 74–935) and the 1‐year survival rate was 37.6%. Grade 3 neutropenia was seen in seven patients and grade 4 in one patient. Grade 3 fatigue, anorexia, mucositis, and diarrhea were observed in three, two, two, and one patient, respectively. This regimen is effective as a first‐line therapy for ESCC with distant metastasis.