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Annals of Oncology Advance Access originally published online on October 6, 2006
Annals of Oncology 2007 18(1):93-98; doi:10.1093/annonc/mdl339
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© 2006 European Society for Medical Oncology

gastrointestinal tumors

Concurrent chemoradiotherapy with twice weekly paclitaxel and cisplatin followed by esophagectomy for locally advanced esophageal cancer

C-C Lin1,2,{ddagger}, C-H Hsu1,2,{ddagger}, JC Cheng1, H-P Wang3, J-M Lee4, K-H Yeh1,2,5, C-H Yang1,2, J-T Lin5, A-L Cheng1,2,5,* and Y-C Lee4,{dagger}

1 Department of Oncology, National Taiwan University Hospital
2 Cancer Research Center, National Taiwan University College of Medicine
3 Department of Emergency Medicine
4 Department of Surgery
5 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

* Correspondence to: Dr A.-L. Cheng, Department of Oncology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan. Tel: +886-2-23123456, ext 7251; Fax: +886-2-23711174; E-mail: andrew{at}ha.mc.ntu.edu.tw

{dagger} Correspondence to: Dr Y.-C. Lee, Department of Surgery, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan. Tel: +886-2-23123456, ext 5070; Fax: +886-2-33933389; E-mail: wuj{at}ha.mc.ntu.edu.tw

Background: To test the feasibility of incorporating a twice-weekly paclitaxel (Taxol) and cisplatin regimen into concurrent chemoradiotherapy (CCRT), followed by surgery, for patients with locally advanced esophageal cancer.

Patients and methods: Patients with operable T3N0-1M0 or T1-3N1M0 esophageal cancer were enrolled. The CCRT regimen included paclitaxel (35 mg/m2 1 h on days 1 and 4/week), cisplatin (15 mg/m2 1 h on days 2 and 5/week), and radiotherapy (2 Gy on days 1–5/week). When the accumulated radiation dose reached 40 Gy, the feasibility of esophagectomy was evaluated in all patients. In patients for whom esophagectomy was not feasible, CCRT was continued to a dose of 60 Gy.

Results: The majority of 97 patients enrolled had squamous cell carcinoma on histology (95%) and T3N1 disease by endoscopic ultrasonographic staging (90%). All patients received CCRT to 40 Gy. Sixty-one patients underwent surgery, and 26 patients continued definitive CCRT to 60 Gy. The intention-to-treat pathological complete response rate was 25% [24/97, 95% confidence interval (CI) 16–33]. At a median follow-up of 25.3 months, the median progression-free and overall survival was 15.6 and 28.8 months, respectively. The most common grade 3/4 toxic effects were leukopenia (30%), thrombocytopenia (10%), and diarrhea (15%).

Conclusions: CCRT with a twice-weekly paclitaxel and cisplatin regimen followed by esophagectomy is an active treatment of locally advanced esophageal cancer.

Key words: combined modality therapy, drug administration schedule, esophageal neoplasms, paclitaxel


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 Ann OncolHome page
D. Ilson, R. Wadleigh, L. Leichman, and D. Kelsen
Paclitaxel given by a weekly 1-h infusion in advanced esophageal cancer
Ann. Onc., May 1, 2007; 18(5): 898 - 902.
[Abstract] [Full Text] [PDF]


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