Abstract

Background: Esophageal cancer is a common gastrointestinal cancer in Vietnam, with squamous cell carcinoma being the most frequent type, associated with risk factors such as alcohol and tobacco use. Patients often detect the disease at a late stage when symptoms are pronounced, making surgery challenging due to extensive localized invasive damage. Therefore, multimodal treatment becomes very important. Concurrent chemoradiotherapy is highly recommended globally and in Vietnam for non-surgical cases, significantly improving overall survival and disease-free survival compared to radiotherapy or chemotherapy alone. Among these, concurrent chemoradiotherapy with Cisplatin/5-Fluorouracil is preferred; however, few studies currently evaluate this regimen's effectiveness in Vietnam.

Methods: A prospective and retrospective descriptive study on 50 patients with stage III-IVA esophageal cancer treated with definitive concurrent chemoradiotherapy with the Cisplatin/5-Fluorouracil regimen and radiation dose of 50.4Gy/28Fx at Hue Central Hospital, from January 2022 to March 2024. Statistical analysis was performed using R software.

Results: The average age was 60.3 years, and all patients were male. Tobacco and alcohol were the two main risk factors. The primary symptoms were dysphagia (98%) and weight loss (92%). The majority of cancers were located in the middle and lower esophagus, with an average tumor length of 62.5±23.1 mm. The overall response rate was 60%, with 16% achieving complete response. The disease-free survival rate at 6 months was 62%, with a median of 7 months. The overall survival rate at 6 months was 94%, with a median of 11 months. The regimen completion rate was 98%. The main toxicities were grade 1 and grade 2, commonly including fatigue, hypokalemia, pain, esophagitis, and decreased hemoglobin. Only one patient had to discontinue treatment due to toxicity.

Conclusion: Definitive concurrent chemoradiotherapy with the Cisplatin/5-Fluorouracil regimen is an effective treatment for stage III-IVA esophageal squamous cell carcinoma that is not amenable to surgery, with acceptable adverse effects.