title: Small cell carcinoma of the esophagus responding to fourth-line chemotherapy with weekly paclitaxel.
abstract: A patient was diagnosed with a small cell carcinoma of the esophagus (T4N1M1b by the International Union Against Cancer [UICC] classification) in October 2002, and initially received two courses of concurrent chemotherapy with 5-fluorouracil (5-FU; 400 mg/m(2) by continuous infusion; days 1-5 and 8-12) and cisplatin (40 mg/m(2) by drip infusion; days 1 and 8) and radiation therapy (2 Gy/day, days 1-5, 8-12, and 15-19; total, 30 Gy per course) with the second course given after a 2-week interval. Two courses of chemotherapy with 5-FU (800 mg/m(2); days 1-5) and cisplatin (80 mg/m(2); day 1) given after this was completed. Although a complete response had been confirmed, recurrence with multiple liver and lymph node metastases was detected 3 months after the cessation of the second course of chemotherapy. Although the patient received second-line chemotherapy with irinotecan (150 mg/m(2); every 2 weeks) from June 2003, the disease progressed. Brain metastases developed during third-line chemotherapy with gemcitabine (1000 mg/m(2) weekly by drip infusion). The symptoms were attenuated after whole-brain radiation (30 Gy), and fourth-line chemotherapy using paclitaxel (80 mg/m(2); weekly) was initiated from November 2003. A computed tomography scan 1 month after the first course of paclitaxel showed remarkable regression of the liver metastases. The treatment strategy used for treating small cell carcinomas of the lung may be applicable for these carcinomas of the esophagus.
authors.affiliation: Division of Gastrointestinal Oncology and Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Shizuoka 411-8777, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Matsuoka
authors.forename: Narikazu
authors.initials: N
authors.lastname: Boku
authors.forename: Takayuki
authors.initials: T
authors.lastname: Yoshino
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hironaka
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Onozawa
authors.forename: Akira
authors.initials: A
authors.lastname: Fukutomi
authors.forename: Sadamoto
authors.initials: S
authors.lastname: Zenda
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yasui
authors.forename: Noriaki
authors.initials: N
authors.lastname: Hasuike
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Inui
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yamaguchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ono
authors.forename: Minoru
authors.initials: M
authors.lastname: Kamata
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000556:secondary; D018288:Carcinoma, Small Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000556:secondary; D008297:Male; D017239:Paclitaxel / Q000008:administration & dosage*; D016879:Salvage Therapy; D014057:Tomography, X-Ray Computed
chemical_list: D017239:Paclitaxel