[Successful Treatment of Advanced Esophageal Cancer with DCF Chemotherapy and Pegfilgrastim]

Docetaxel, cisplatin, and 5-FU(DCF)chemotherapy for esophageal cancer has been reported to be highly effective, but often causes serious adverse events, including severe bone marrow suppression. We report the successful treatment of a 67- year-old man with highly advanced esophageal cancer with invasion of the left bronchus and broad lymph node metastases. He received induction chemotherapy with DCF therapy, and prophylactic administration of pegfilgrastim. He safely completed 5 courses of DCF therapy without serious adverse events, such as neutropenia and febrile neutropenia. The size of the primary tumor and lymph node metastases remarkably reduced after the third course of DCF. He underwent thoracoscopic esophagectomy with three-field lymph node dissection and reconstruction with a gastric tube. The pathological findings of the resected specimen showed no viable malignant cells in the primary lesion and the pathological effect after chemotherapy was judged as Grade 3. Viable cancer cells still remained in 10 lymph nodes in the dissected field. DCF therapy with prophylactic administration of pegfilgrastim may be an effective and safe treatment for advanced esophageal cancer.