The experience of using chemoradiotherapy for esophageal cancer with the FOLFOX chemotherapy regimen

Introduction. For an extended period, numerous studies have been conducted to find the optimal treatment regimen for esophageal cancer. Chemoradiotherapy has demonstrated satisfactory results in the treatment of localized and locally advanced forms of this disease. However, the search for the best chemotherapy regimen in combination with radiotherapy remains a current focus of many researchers. Aim. To evaluate the effectiveness and safety of chemoradiotherapy (CRT) using the FOLFOX regimen in patients with esophageal cancer. Materials and methods. A prospective study was conducted at the Ulyanovsk Regional Clinical Oncology Dispensary. The analysis included patients who received chemoradiotherapy with the FOLFOX regimen from December 1, 2022, to March 1, 2024. A total of 19 cases of esophageal cancer treatment at stages I–III were analyzed. Radical surgical treatment was subsequently performed on 5 patients (26.3%). The characteristics of the studied patients were evaluated according to a standardized protocol. Results. In the study group, 18 patients (94.7%) completed the planned course of treatment. One patient received an incomplete course of radiotherapy but completed the entire planned chemotherapy. The most common hematologic complication was leukopenia, observed in 9 patients (47.3%) after the full course of chemoradiotherapy. No cases of febrile neutropenia were reported. The hematologic complications were manageable and did not lead to the discontinuation of treatment. Among non-hematologic complications, the most frequently reported were grade 1–2 nausea in 11 patients (58%) and grade 1–2 vomiting in only 2 cases (10%), which was effectively controlled with antiemetic therapy. Overall and relapse-free survival were assessed. The reason for discontinuing radiotherapy in 1 patient (5.3%) was ulcerative stomatitis. Surgery was performed on 5 patients, with tumor regression (TRG) grades 1–2 according to the Mandard scale observed in 4 of them (80%). One patient (20%) had a TRG 3 response. Conclusions. After chemoradiotherapy with the FOLFOX regime in patients with squamous cell carcinoma of the esophagus, the rate of therapeutic tumor regression (TRG1–2) in operated patients reached 80%. One-year relapse-free survival was 58%, one-year overall survival was 73%, indicating the effectiveness and safety of this chemotherapy regimen as part of the comprehensive treatment of esophageal cancer.