title: A phase II study of concurrent chemoradiotherapy and erlotinib for inoperable esophageal squamous cell carcinoma.
abstract: Cisplatin-based concurrent chemoradiotherapy for patients with unresectable, locally advanced esophageal squamous cell carcinoma (ESCC) is associated with significant toxicities that are often intolerable. Prognosis for this subgroup of patients remains poor, and new therapeutic approaches are urgently needed. We investigated the efficacy and safety of paclitaxel combined with erlotinib and concurrent radiotherapy in patients with inoperable ESCC. Erlotinib (150 mg) was administered daily for 60 days beginning at the start of radiotherapy, and paclitaxel (45 mg/m²) was administered weekly along with intensity modulated conformal radiotherapy (60 Gy in 30 fractions). The median follow-up time was 21 months. The associations between EGFR and VEGF expression and treatment outcome were evaluated. Among the 21 patients treated, the overall response rate (CR + PR) was 85.6%. The median LPFS, PFS and OS were: 17.5, 14.3, and 22.9 months, respectively. Treatment-related grade 3 toxicities included esophagitis (two patients) and hypoleukemia (one patient). Grade 4 pulmonary toxicity was observed in one patient. Patients expressing EGFR had longer PFS, while those expressing VEGF or with a history of smoking had worse outcomes. Weekly paclitaxel combined with erlotinib and concurrent radiotherapy shows promise as an effective, tolerated regimen for patients with inoperable ESCC.
authors.affiliation: Department of GI Oncology, 307 Hospital of PLA, Academy of Military Medical Sciences, Beijing, China.
authors.forename: Chuanhua
authors.initials: C
authors.lastname: Zhao
authors.affiliation: Department of GI Oncology, 307 Hospital of PLA, Academy of Military Medical Sciences, Beijing, China.
authors.forename: Li
authors.initials: L
authors.lastname: Lin
authors.affiliation: Department of GI Oncology, 307 Hospital of PLA, Academy of Military Medical Sciences, Beijing, China.
authors.forename: Jianzhi
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of GI Oncology, 307 Hospital of PLA, Academy of Military Medical Sciences, Beijing, China.
authors.forename: Rongrui
authors.initials: R
authors.lastname: Liu
authors.affiliation: Department of GI Oncology, 307 Hospital of PLA, Academy of Military Medical Sciences, Beijing, China.
authors.forename: Yuling
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of GI Oncology, 307 Hospital of PLA, Academy of Military Medical Sciences, Beijing, China.
authors.forename: Feijiao
authors.initials: F
authors.lastname: Ge
authors.affiliation: Department of GI Oncology, 307 Hospital of PLA, Academy of Military Medical Sciences, Beijing, China.
authors.forename: Ru
authors.initials: R
authors.lastname: Jia
authors.affiliation: Department of GI Oncology, 307 Hospital of PLA, Academy of Military Medical Sciences, Beijing, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Jin
authors.affiliation: Department of GI Oncology, 307 Hospital of PLA, Academy of Military Medical Sciences, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of GI Oncology, 307 Hospital of PLA, Academy of Military Medical Sciences, Beijing, China.
authors.forename: Jianming
authors.initials: J
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000532:radiotherapy*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D000069347:Erlotinib Hydrochloride / Q000008:administration & dosage*; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009154:Mutation; D017239:Paclitaxel / Q000008:administration & dosage; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069347:Erlotinib Hydrochloride; D017239:Paclitaxel; D002945:Cisplatin
keywords: chemoradiotherapy; epidermal growth factor receptor; erlotinib; esophageal cancer; paclitaxel