DCF Neoadjuvant Chemotherapy Protocol

DCF therapy consisted of intravenous infusion of DOC (70 mg/m²) for 1 h, followed by intravenous infusion of CDDP (70 mg/m²; dosage was adjusted according to Ccr) for 2 h on day 1, and continuous intravenous infusion of 5-FU (700 mg/m²) from days 1 to 5. In this study, one cycle of 21 days or 28 days was adopted for the purpose of neoadjuvant chemotherapy (NAC) or other purposes (e.g., treatment for unresectable/recurrent esophageal cancer, hereafter referred to as “non-NAC”), respectively. Oral levofloxacin (500 mg; dosage adjusted according to Ccr) was administered to all patients from days 5 to 15 as prophylaxis for FN. MgSO₄ (20 mEq) was administered before CDDP administration, and adequate hydration with normal saline was administered [32 (link)], to avoid CDDP-induced renal dysfunction. In our institute, PEG-G is administered on day 7 of DCF therapy because the G-CSF guideline [33 (link)] recommends administering it 24 h after anticancer drug administration.
The antiemetic agents used were neurokinin 1 (NK₁) receptor antagonist ((fos)aprepitant), serotonin (5-hydroxytryptamine)-3 (5-HT₃) receptor antagonist (palonosetron), and dexamethasone [34 (link)]. The patients received oral aprepitant (125 mg) or intravenous fosaprepitant (150 mg) on day 1. Intravenous palonosetron (0.75 mg) and dexamethasone (9.9 mg) were administered on day 1, followed by intravenous dexamethasone (6.6 mg) on days 2–5. The patients also received oral aprepitant (80 mg) on days 2 and 3 when they received oral aprepitant on day 1.