ORIGINAL ARTICLE Neoadjuvant chemotherapy using concurrent Docetaxel/CDDP/ 5-FU (DCF) in esophageal squamous cell carcinoma and its short-term prognosis Natsuya Katada • Keishi Yamashita • Chikatoshi Katada • Hiromitsu Moriya • Kei Hosoda • Hiroaki Mieno • Katsuhiko Higuchi • Shoko Komori • Hiromichi Ishiyama • Kazushige Hayakawa • Mitsuhiro Sugawara • Satoshi Tanabe • Wasaburo Koizumi • Shiro Kikuchi • Masahiko Watanabe Received: 17 September 2013 / Accepted: 28 January 2014 / Published online: 19 February 2014 Ó The Japan Esophageal Society and Springer Japan 2014 Abstract Background Our aim in this study is to know whether clinical outcomes are improved by neoadjuvant chemo- therapy (NAC) using Docetaxel/CDDP/5-FU (DCF) as compared to NAC using 5-FU/CDDP (FP). Methods Thirty-eight patients who underwent DCF NAC in cStage II/III esophageal squamous cell carcinoma (ESCC) were compared with the 41 counterparts treated by FP NAC. Docetaxel and CDDP were both given to 70–75 mg/m 2 with concurrent 5-FU at 750 mg/m 2 in 3 cycles. Median follow-up term of DCF NAC reached 27 months. Results In DCF NAC, grade 3 adverse effects were rec- ognized in 97 %, and completion rate of the DCF NAC was 86 %. In terms of PR ? CR rate, DCF NAC was better (87 %) than FP NAC (59 %) (p = 0.005). Five year pro- gression-free survival (PFS) and overall survival (OS) of FP NAC were 32 and 69 %, respectively, and OS of FP NAC was excellent putatively due to adoption of definitive chemoradiation therapy for recurrent diseases. Further- more, survival was in favor of DCF NAC as compared to FP NAC for OS (p = 0.02) and PFS (p = 0.10), while R0 resection rate was similar. The 1st multivariate prognostic analysis among all cases with NAC revealed that signifi- cant factors were resectability and NAC modality for OS and PFS. We then performed the 2nd stage multivariate prognostic analysis limited to R0 cases including patho- logic factors, which again identified DCF NAC modality as an independent prognostic factor. Conclusion DCF NAC for ESCC demonstrated high response rates, and may improve patient survival with acceptable feasibility. Keywords Esophageal squamous cell carcinoma Á Neoadjuvant chemotherapy Á Clinical outcome Á Multivariate analysis Introduction Esophageal cancer is a dismal disease, with possible distant metastasis. Surgery alone cannot reach the best survival outcome, and an adjuvant therapy may be required to improve survival outcome. In the Western countries, neo- adjuvant chemoradiation therapy (NCRT) is a standard treatment for localized esophageal cancer, and overall survival (OS) was 30–40 % at 5 years [1–3]. On the other hand, in Japan, surgery alone or surgery plus postoperative chemotherapy reached over 40 % of OS at 5 years [4, 5], and recent randomized phase III trial (JCOG9907) actually demonstrated that better OS (*55 % at 5 years) was rec- ognized by neoadjuvant chemotherapy (NAC) than post- operative chemotherapy using 5-FU/CDDP (FP) regimen [5]. N. Katada (&) Á K. Yamashita Á H. Moriya Á K. Hosoda Á H. Mieno Á S. Kikuchi Á M. Watanabe Department of Surgery, Kitasato University School of Medicine, 2-1-1 Asamizodai, Minami-ku, Sagamihara, Kanagawa 252-0380, Japan e-mail: katada@kitasato-u.ac.jp C. Katada Á K. Higuchi Á S. Tanabe Á W. Koizumi Department of Gastrointestinal Oncology, Kitasato University School of Medicine, Sagamihara, Japan S. Komori Á H. Ishiyama Á K. Hayakawa Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, Sagamihara, Japan M. Sugawara Department of Pharmacy, Kitasato University School of Medicine, Sagamihara, Japan 123 Esophagus (2014) 11:173–181 DOI 10.1007/s10388-014-0422-z