Efficacy and safety of first-line modified docetaxel, cisplatin, and fluorouracil (mDCF) in advanced esophageal cancer: A retrospective study from Viet Nam.

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Background: In Viet Nam, most advanced esophageal cancer patients cannot access combined immunotherapy due to high costs; thus, chemotherapy remains the primary option. Docetaxel, cisplatin, and fluorouracil (DCF) was the standard three-drug regimen, with high response rates but many side effects. The mDCF regimen has been suggested as effective and tolerable, although data are limited. This retrospective study evaluates the efficacy and safety of mDCF in Viet Nam. Methods: We conducted a retrospective study of 61 male patients with squamous cell carcinoma of the esophagus who received the mDCF regimen as first-line therapy at Viet Nam National Cancer Hospital. Patients were treated from January 2022 to January 2025. Protocol regimen: docetaxel 40 mg/m ² , cisplatin 40 mg/m ² , leucovorin 400 mg/m ² , 5-FU 400 mg/m ² IV bolus, and 5-FU 2000 mg/m ² as a 48-hour continuous infusion, every 14 days until disease progression or unacceptable toxicity. Primary endpoints: disease control rate (DCR) and progression-free survival (PFS), secondary endpoints: overall survival (OS) and adverse events. Results: The median age was 57 (range 40-74); ECOG PS 0/1/2: 49.1%/47.5%/3.4%. Median number of cycles was 8 (range 4–17). The DCR reached 83.6%, with complete response, partial response, disease stability, and disease progression accounting for 4.9%, 55.7%, 23.0%, 16.4%, respectively. Median PFS was 6.2 months. Median OS was 12.9 months. Grade 3-4 hematologic toxicities were neutropenia, occurring in 6.5% of patients. Primary prophylactic G-CSF Granulocyte-Colony Stimulating Factor) was used in 36.1% patients. Non-hematologic adverse events were grade 1 or 2 and were manageable. Conclusions: First-line mDCF is an effective protocol with a tolerable and controllable toxicity profile for advanced esophageal cancer.