***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : The st and ard treatment for locally advanced unresectable squamous cell carcinoma ( SCC ) of the oesophagus is chemoradiation with cisplatin and 5-fluorouracil ( CF-RT ) . This multicentre phase II trial assessed the safety and efficacy of chemo selection with docetaxel plus cisplatin and 5-fluorouracil ( DCF ) induction chemotherapy ( ICT ) and subsequent conversion surgery ( CS ) for initially unresectable locally advanced SCC of the oesophagus . Methods : Patients with clinical T4 and /or unresectable supraclavicular lymph node metastasis were eligible . Treatment started with three cycles of DCF-ICT , followed by CS if resectable , or by CF-RT if unresectable . The resectability was re-evaluated at 30–40 Gy of CF-RT , followed by CS if resectable , or by completion of 60 Gy of CF-RT . If resectable after CF-RT , CS was performed . The primary end point was 1-year overall survival ( OS ) . Results : From April 2013 to July 2014 , 48 patients were enrolled .  CS was performed in 41.7 % ( n=20 ) , including DCF-CS ( n=18 ) , DCF-CF-RT40Gy-CS ( n=1 ) , and DCF-CF-RT60Gy-CS ( n=1 ) . R0 resection was confirmed in 19 patients ( 39.6 % ) . Grade ⩾3 postoperative complications included one event each of recurrent laryngeal nerve palsy , lung infection , wound infection , pulmonary fistula , and dysphagia ; but no serious postoperative complications were observed in patients undergoing CS . Clinical complete response after CF-RT was confirmed in 4 patients ( 8.3 % ) . The estimated 1-year OS was 67.9 % and lower limit of 80 % confidence interval was 59.7 % . There was one treatment-related death in patient receiving DCF-CF-RT60Gy . Conclusions : Chemo selection with DCF-ICT followed by CS as a multidisciplinary treatment strategy showed promising signs of tolerability and efficacy in patients with locally advanced unresectable SCC of the oesophagus The need for surgery after chemoradiotherapy for a T4N0 - 1M0 squamous cell carcinoma in the thoracic esophagus was evaluated . A series of 53 patients were enrolled in this prospect i ve nonr and omized trial from among 124 patients with an esophageal cancer assessed as T4 in Kurume University Hospital from 1994 to 2002 . After the first chemoradiotherapy cycle , which consisted of radiotherapy in a total dosage of 36 Gy and chemotherapy using cisplatin ( CDDP ) and 5-fluorouracil ( 5FU ) , the patients each decided , after being informed of the efficacy of the chemoradiotherapy , whether to undergo surgery . All patients , including those who had undergone surgery and those who had not , later underwent a second chemoradiotherapy cycle consisting of radiotherapy in a total dosage of 24 Gy and chemotherapy using CDDP and 5FU , as far as practicable . Among the responders to the first chemoradiotherapy cycle , there was no significant difference in the long-term ( 5-year ) survival rate between the 18 patients who underwent esophageal surgery and the 13 patients who did not ( 23 % vs. 23 % ) . Among the nonresponders , the 11 patients who underwent surgery showed a tendency toward longer survival than the five patients who had had no surgery . The nonresponders had 1- and 2-year survival rates of 64 % and 33 % , respectively . The corresponding rates for the 5 nonsurgical patients who completed the two chemoradiotherapy cycle were 20 % and s 20 % , respectively . For a T4N0 - 1M0 squamous cell carcinoma in the thoracic esophagus , full-dosage chemoradiotherapy ( definitive chemoradiotherapy ) is preferred for responders to a half-dose of chemoradiotherapy as much as esophagectomy , whereas esophagectomy may be preferred for nonresponders BACKGROUND A r and omized phase 3 trial of the treatment of squamous-cell carcinoma of the head and neck compared induction chemotherapy with docetaxel plus cisplatin and fluorouracil ( TPF ) with cisplatin and fluorouracil ( PF ) , followed by chemoradiotherapy . METHODS We r and omly assigned 501 patients ( all of whom had stage III or IV disease with no distant metastases and tumors considered to be unresectable or were c and i date s for organ preservation ) to receive either TPF or PF induction chemotherapy  , followed  by chemoradiotherapy with weekly carboplatin therapy and radiotherapy for 5 days per week . The primary end point was overall survival . RESULTS With a minimum of 2 years of follow-up ( > or =3 years for 69 % of patients ) , significantly more patients survived in the TPF group than in the PF group ( hazard ratio for death , 0.70 ; P=0.006 ) . Estimates of overall survival at 3 years were 62 % in the TPF group and 48 % in the PF group ; the median overall survival was 71 months and 30 months , respectively ( P=0.006 ) . There was better locoregional control in the TPF group than in the PF group ( P=0.04 ) , but the incidence of distant metastases in the two groups did not differ significantly ( P=0.14 ) . Rates of neutropenia and febrile neutropenia were higher in the TPF group ; chemotherapy was more frequently delayed because of hematologic adverse events in the PF group . CONCLUSIONS Patients with squamous-cell carcinoma of the head and neck who received docetaxel plus cisplatin and fluorouracil induction chemotherapy plus chemoradiotherapy had a significantly longer survival than did patients who received cisplatin and fluorouracil induction chemotherapy plus chemoradiotherapy . ( Clinical Trials.gov number , NCT00273546 [ Clinical Trials.gov ] . ) Purpose St and ard care for unresectable locally advanced esophageal squamous cell carcinoma ( ESCC ) is concurrent chemoradiotherapy , but survival remains limited . Neoadjuvant chemotherapy with docetaxel , cisplatin and fluorouracil ( DCF ) has demonstrated promising activity , with a pathological complete response ( CR ) of 17 % for resectable stage II/III ESCC . Here , we conducted a multicenter study to assess the efficacy and safety of induction chemotherapy with DCF followed by CRT in patients with unresectable locally advanced ESCC . Methods Eligibility criteria included clinical T4 and /or M1 lymph node ESCC , PS 0–1 and age 20–70 years . Treatment consisted of docetaxel 70 mg/m2 and cisplatin 70 mg/m2 on day 1 , and fluorouracil 750 mg/m2 on days 1–5 , repeated every 3 weeks for three cycles , followed by cisplatin 70 mg/m2 on days 64 and 92 , and fluorouracil 700 mg/m2 on days 64–67 and 92–95 , concurrently with radiotherapy ( 60 Gy in 30 fractions , 5 days/week ) . Primary endpoint of the phase II part was CR rate . Results Thirty-three patients were enrolled . The completion rate of protocol treatment was 88 % . Thirteen patients ( 39.4 % ) achieved a CR . With a median follow-up period of 41 months ( range 24–49 months ) , median progression-free survival was 12.2 months , and median survival was 26.0 months , with a survival rate of 40.4 % at 3 years . The most common grade 3 or 4 toxicities were neutropenia , leukopenia , anorexia and dysphagia . No treatment-related death was observed . Conclusion Induction chemotherapy with DCF followed by CRT is tolerable and shows promising efficacy for unresectable locally advanced ESCC Background This phase II trial evaluated the efficacy of cisplatin and fluorouracil (CF)-based combination neoadjuvant chemotherapy on the outcome of patients with resectable locally advanced esophageal squamous cell carcinoma ( ESCC ) . We compared the recurrence-free survival ( RFS ) associated with CF plus Adriamycin ( ACF ) with that associated with CF plus docetaxel ( DCF ) to select an alternative regimen in a new phase III trial investigating the optimal neoadjuvant treatment of patients with ESCC . Patients and methods Patients with resectable advanced ESCC were r and omly assigned to either ACF ( Adriamycin 35 mg/m2 , cisplatin 70 mg/m2 i.v . on day 1 , fluorouracil 700 mg/m2 continuous infusion for 7 days ) every 4 weeks or DCF ( docetaxel 70 mg/m2 , cisplatin 70 mg/m2 i.v . on day 1 , fluorouracil 700 mg/m2 continuous infusion for 5 days ) every 3 weeks . Surgery was scheduled after completion of two cycles of chemotherapy . The primary end point was RFS , analyzed by the intention-to-treat . Results Between October 2011 and October 2013 , 162 patients at 10 institutions were enrolled in the study , all of whom were eligible and r and omly assigned to the two groups ( 81 to the ACF group and 81 to the DCF group ) . The R0 resection rates for the ACF and DCF groups were equivalent ( 95.9 % versus 96.2 % , P = 0.93 ) . The 2-year RFS and overall survival rates  for DCF versus ACF were 64.1 % versus 42.9 % ( hazard ratio 0.53 , 95 % confidence interval 0.33 - 0.83 , P = 0.0057 ) and 78.6 % versus 65.4 % ( P = 0.08 ) , respectively . Conclusion Compared with ACF , DCF chemotherapy was associated with prolonged RFS for patients with resectable advanced ESCC . Thus , DCF chemotherapy has potential as a st and ard neoadjuvant therapy for resectable ESCC . Clinical Trial Registration University Hospital Medical Information Network Clinical Trials Registry of Japan ( identification number UMIN000004555/000004616 ) Background We hypothesized that the survival rate of patients undergoing R0 esophagectomy after induction chemotherapy or chemoradiotherapy for unresectable T4 esophageal cancer ( URT4 ) would be similar to that of patients undergoing esophagectomy for immediately resectable esophageal cancer with no unfavorable prognostic factors ( RNU ) . Methods Between April 2002 and June 2012 , 87 of 283 patients with esophageal cancer who presented at the University Hospital of the Ryukyus were enrolled in this prospect i ve cohort study . Tumors were classified as RNU and URT4 in 44 and 43 of the 87 patients , respectively . Outcomes of treatment for URT4 patients were compared with those of RNU patients . Results The R0 resection rate ( 61 % ) and in-hospital mortality rate ( 20 % ) of URT4 patients were significantly poorer than those of RNU patients ( 98 and 2.3 % , respectively ) , although the morbidity rate was similar in the two groups ( 63 and 52 % , respectively ) . The 5-year survival rate ( 35 % ) of URT4 patients was significantly poorer than that of RNU patients ( 67 % ) in the intention-to-treat analysis . However , no significant difference was noted between the two survival curves for cases of R0 resection ( 5-year survival rate , 60 % vs. 69 % ) . Multivariate analysis revealed R status as the only significant independent prognostic factor for URT4 patients ( P < 0.001 ; hazard ratio = 8.279 ) . Conclusions Satisfactory survival rates can be achieved if R0 resection is performed after induction treatment in patients with T4 esophageal cancer , although secondary radical esophagectomy is associated with a higher risk of in-hospital mortality This study was performed to assess the efficacy and safety of docetaxel , cisplatin and fluorouracil combination in patients with unresectable locally advanced oesophageal squamous cell carcinoma . Treatment consisted of docetaxel 60 mg m−2 , cisplatin 75 mg m−2 on day 1 and fluorouracil 750 mg m−2 day−1 on days 2–5 , repeated every 3 weeks for three cycles , followed by carboplatin 100 mg m−2 week−1 for 5 weeks and concurrent radiotherapy ( 45 Gy in 25 fractions , 5 days week−1 ) . After radiotherapy , eligible patients either underwent an oesophagectomy or received high dose rate endoluminal brachytherapy ( HDR-EBT ) .  Thirty-one out of 37 enrolled patients completed the planned chemotherapy and 30 completed chemoradiation . After completion of chemotherapy , 49 % ( 95 % CI : 32.2–66.2 ) had a clinical response . Twelve patients ( 32 % ) underwent a resection , which was radical in 60 % ( postoper 
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Results / Conclusion We found that CS was superior to dCRT with respect to local disease control and short-term survival ; however , CS was associated with relatively higher perioperative mortality and morbidity .
Alternatively , although dCRT might often cause fistula formation , a clinical complete response to dCRT is likely to lead to a better prognosis .
Recent advances in chemotherapeutic agents have led to triple induction chemotherapy , with docetaxel , cisplatin , and 5-fluorouracil ( DCF ) , which has shown promise as an initial induction treatment for cT4 esophageal cancer .
Indeed , this regimen could control both local and systemic disease , which enables curative resection without preoperative CRT .
Moreover , some appropriate changes in perioperative management and intensive systemic chemotherapy might enhance patient outcome .