Telephone Follow-Ups May Reduce AEs in Locally Advanced ESCC

Telephone follow-up may reduce non-hematologic toxicities, such as stomatitis, in ESCC patients receiving DCF chemotherapy.

A telephone follow-up program may reduce non-hematologic toxicities like stomatitis during treatment with docetaxel, cisplatin, and 5-fluorouracil (DCF) in patients with locally advanced esophageal squamous cell carcinoma (ESCC), recent study findings suggest.

Findings from this study were presented as a poster at the 2025 ASCO Gastrointestinal Cancers Symposium.

“Specific toxicities such as stomatitis during [docetaxel, cisplatin and 5-fluorouracil] therapy may be reduced by Tsukiji Call by nurses in the hospital, which is clinically useful in preventing severe adverse events,” the study authors wrote in the poster.

The telephone follow-up program was initiated on days 8 through 14 of the first course of neoadjuvant DCF therapy, according to the abstract. The program was conducted by nurses at the hospital, who called patients at home before their first outpatient clinic visit. During this call, nurses checked for nausea, fever, constipation, vomiting, stomatitis, and diarrhea based on the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.

The study included 90 patients with locally advanced ESCC, 20 of whom underwent follow-up with the program—called Tsukiji Call— and 70 who did not undergo follow-up with this program.

In the first outpatient clinic visit, no patients in either group experienced grade 2 or higher fever as an adverse event (AE; P = 1). Nausea was reported in 10% of patients in the Tsukiji Call group compared with 1% of those in the non-Tsukiji Call group (P = .123). Other grade 2 or higher AEs assessed in the Tsukiji Call and non-Tsukiji Call groups were vomiting (0% for both groups; P = 1), constipation (0% for both groups; P = 1), diarrhea (0% vs. 5%, respectively; P = .572), and stomatitis (0% vs. 14%; P = .109).

“Stomatitis at the [outpatient visits] with Tsukiji Call group tended to be lower frequency compared to [the] without-Tsukiji Call group,” as noted in the poster.

Any-grade AEs occurred in 10% of those in the Tsukiji Call group compared with 21% in the non-Tsukiji Call group (P = .342). Researchers noted in the abstract that 1 patient in each group was admitted to the hospital within 7 days after discharge.

Study Background and Design

In Japan, where the study was conducted, the standard neoadjuvant treatment for resectable locally advanced ESCC is docetaxel, cisplatin, and 5-fluorouracil, according to the abstract. This therapy is administered over 3 weeks, the first of which is done at the hospital and the other 2 completed at home.

“After the administration of neoadjuvant [docetaxel, cisplatin, and 5-fluorouracil] therapy, patients might suffer from febrile neutropenia or gastrointestinal symptoms such as nausea, vomiting, constipation, diarrhea, and stomatitis even during the [remaining] 2 weeks at home,” the study authors wrote in the abstract. “Therefore, nurses in our hospital teach self-care at home for these patients who received neoadjuvant [docetaxel, cisplatin, and 5-fluorouracil] therapy.”

Despite these efforts, researchers noted that some patients experienced emergency admission due to worsening AEs. As a way to potentially prevent these from occurring, nurses in this hospital conducted a telephone follow-up program for those treating at home.

In this retrospective analysis, researchers analyzed data from patients with locally advanced ESCC who received neoadjuvant docetaxel, cisplatin, and 5-fluorouracil therapy in the hospital between February 2023 and July 2024.

These patients were divided into 2 groups: the Tsukiji Call and non-Tsukiji Call. Researchers used Fisher’s exact test to assess for the frequency of grade 2 or higher AEs in the first outpatient clinic visit.

The median age of patients in the non-Tsukiji Call group was 64 years (range, 46-79) and 66.5 years (45-76) for the Tsukiji Call group. The Tsukiji Call group had 75% male compared with 70% males in the non-Tsukiji Call group. Most patients in the Tsukiji Call and non-Tsukiji Call group had an ECOG performance status of 0 (95% and 96%, respectively). Regarding cancer stage, more than half of patients in the non-Tsukiji Call and Tsukiji Call groups had stage III disease (71% and 55%, respectively).

Reference

Tanaka A, Tanaka R, Yamamoto S, et al. Clinical utility of nurses’ telephone follow-up program (Tsukiji Call) for resectable locally advanced esophageal squamous cell carcinoma patients received neoadjuvant DCF therapy. J Clin Oncol. 2025;43(suppl 4):384. doi:10.1200/JCO.2025.43.4_suppl.384