Short Hydration CDDP/5-Fu + Immune Checkpoint Inhibitor Therapy Using an Infuser Pump for Unresectable Recurrent Esophageal Cancer AIming at Improving Qol

Background In Japan, the main drug therapy for advanced recurrent esophageal cancer is CDDP +5-FU therapy (hereafter referred to as FP therapy). In recent years, survival times have been extended by combining this with immune checkpoint inhibitors (hereafter referred to as ICI). Extended survival times translate into extended treatment periods, and the number of cycles of anticancer drugs that can be administered has also increased. However, FP therapy is generally performed during hospitalization, and hospitalization itself is thought to lead to a decline in quality of life. Methods Therefore, we introduced short hydration FP + ICI therapy, which involves short hydration during CDDP administration and administration of 5-FU using an infuser pump, with the aim of shortening hospital stays. The short hydration method involves taking fluids orally instead of intravenous loading during CDDP administration, which eliminates the need for intravenous loading before administration. In addition, by placing a CV port and administering 5-FU using an infuser pump, it is possible to transition to outpatient care without the need for long-term hospitalization. Results By performing short hydration FP + ICI therapy, CDDP could be administered without significant deterioration of renal function, and continuous administration of 5-FU could also be safely transferred to outpatient care. When initially introduced, the treatment was performed on an inpatient basis until the end of 5-FU administration, and after confirming tolerability, it was decided whether or not a second cycle could be continued. When the treatment began, a multidisciplinary conference was held with doctors, pharmacists, nurses, etc., and efforts were made to reduce patient anxiety by working together with a range of professionals. Conclusion Short hydration FP + ICI therapy shortens the length of hospitalization and allows patients to continue their daily lives while receiving treatment, which improves their QOL by allowing them to continue working or pursuing their hobbies or spend more time with their family. It is believed that short hydration FP + ICI therapy using an infuser pump has the potential to improve QOL compared to conventional FP therapy.