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Annals of Oncology Advance Access published online on October 6, 2006
Annals of Oncology, doi:10.1093/annonc/mdl339
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© 2006 European Society for Medical Oncology
Received May 26, 2006
Revised August 3, 2006
Accepted August 14, 2006

original article

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

C.-C. Lin 1 {ddagger}, C.-H. Hsu 1 {ddagger}, J. C. Cheng 2, H.-P. Wang 3, J.-M. Lee 4, K.-H. Yeh 5, C.-H. Yang 1, J.-T. Lin 6, A.-L. Cheng 5 *, and Y.-C. Lee 4

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

* To whom correspondence should be addressed.
A.-L. Cheng, E-mail: andrew{at}ha.mc.ntu.edu.tw


  Abstract

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.

Keywords: combined modality therapy; drug administration schedule; esophageal neoplasms; paclitaxel.

{ddagger}These authors contributed equally to this study.


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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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