Concurrent cisplatin, paclitaxel, and radiotherapy as preoperative treatment for patients with locoregional esophageal carcinoma.
BACKGROUND
A Phase II trial was conducted at the University of Michigan to determine the efficacy of a preoperative regimen of concurrent cisplatin, paclitaxel, and radiation for patients with locoregional esophageal carcinoma.


METHODS
Sixty-nine patients with esophageal carcinoma were treated with cisplatin 75 mg/m(2) on Day 1, paclitaxel 60 mg/m(2) on Days 1, 8, 15, and 22, and radiation 1.5 Gray (Gy) twice per day on Days 1-5, 8-12, and 15-19, for a total dose of 45 Gy. Transhiatal esophagectomy was performed on approximately Day 50.


RESULTS
The treatment regimen was well tolerated. Only 13% of patients developed Grade 3 or 4 neutropenia and 17% of patients required feeding tubes. Ninety percent of all patients had complete tumor resection at the time of surgery. Nineteen percent of patients achieved a complete histologic response in the resected specimen. The median survival period was 24 months. One-, 2-, and 3-year survival probabilities were 75%, 50%, and 34%, respectively.


CONCLUSIONS
This cisplatin-based preoperative regimen, which contained paclitaxel rather than 5-fluorouracil, was well tolerated. The survival data compared favorably with other previously reported combinations. This regimen is a reasonable preoperative approach for patients with localized esophageal carcinoma.
Division of Hematology/Oncology, University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan 48109, USA. surba@umich.edu
Susan G
SG
Urba
Mark B
MB
Orringer
Mark
M
Ianettonni
James A
JA
Hayman
Hayasaka
H
Satoru
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009503:Neutropenia / Q000139:chemically induced; D017239:Paclitaxel / Q000008:administration & dosage; D018714:Radiotherapy, Adjuvant; D016019:Survival Analysis
D017239:Paclitaxel; D002945:Cisplatin