Analysis of the adverse events of standard neoadjuvant chemotherapy used for esophageal cancer

Abstract

Objective : To study the adverse events associated with neoadjuvant chemotherapy (NAC) used for esophageal cancer, and the factors relating to them. Method : The data of 25 patients who had NAC consisting of 5FU and cisplatin followed by curative resection for advanced thoracic esophageal cancer in our department from July 2007 to February 2009 were analyzed. Adverse events that were grade 3 or 4 which were recorded according to NCI-CTC version 3.0 were retrospectively retrieved. Results : Grade 3 or 4 adverse events of occurred in 10 patients (40%). Neutropenia was observed in 9 ; 3 of these patients developed febrile neutropenia. Compared to the 15 patients without adverse events which were grade 3 or 4, 10 with grade 3 or 4 adverse events were : older (mean 64 years versus 56.8 years, p=0.02), had a lower BMI (mean 19.3 versus 22.4, p=0.04), and had a higher rate of IVH during NAC (5/10 (50%) versus 2/15 (13%), p=0.08). The three patients with febrile neutropenia all had IVH. Conclusion : NAC at standard dose intensity frequently causes grade 3 or 4 adverse events in elderly patients, and in patients with a nutritional disorder.