title: Clinical outcomes of definitive chemoradiotherapy using carboplatin and paclitaxel in esophageal cancer.
abstract: Patients with nonmetastatic esophageal cancer not suitable for surgery can be treated with definitive chemoradiotherapy with curative intent. The purpose of this retrospective study is to evaluate the clinical outcomes of definitive chemoradiotherapy using carboplatin and paclitaxel. Medical records were reviewed of patients treated for nonmetastatic squamous cell or adenocarcinoma of the esophagus between January 2009 and December 2013 in two collaborating institutes. Treatment consisted of external beam radiotherapy (28 fractions of 1.8 Gy) and 6 weekly courses of carboplatin (AUC = 2) and paclitaxel (50 mg/m2). Data on survival, progression, toxicity, and effect on dysphagia were recorded. Sixty-six patients were included. Median overall survival (OS) was 13.1 months (95% CI 4.7-21.5 months) and a 2-year OS was 30% (95% CI 18%-42%). At 2 years, 26% of patients developed local progression (95% CI 15%-37%) and 49% developed distant metastases (95% CI 36%-64%). Acute toxicity grade ≥3 was observed in 47% of patients. Late adverse events grade ≥3 were seen in 20%, mostly esophageal stenoses. Of patients with available data 3 months after treatment, 70% had relief of dysphagia. Definitive chemoradiotherapy led to a median OS of 13 months. Toxicity was common, mostly due to hematological toxicity. Given the relatively short median survival, an adequate selection of patients for this intensive treatment is required.
authors.affiliation: Leiden University Medical Centre, Department of Radiation Oncology, Leiden, the Netherlands.
authors.forename: M A P
authors.initials: MA
authors.lastname: van Ruler
authors.affiliation: Leiden University Medical Centre, Department of Radiation Oncology, Leiden, the Netherlands.
authors.forename: F P
authors.initials: FP
authors.lastname: Peters
authors.affiliation: Leiden University Medical Centre, Department of Medical Oncology, Leiden, the Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Slingerland
authors.affiliation: Leiden University Medical Centre, Department of Medical Statistics and Bioinformatics, Leiden, the Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Fiocco
authors.affiliation: Reinier de Graaf Hospital, Department of Radiation Oncology, Delft, the Netherlands.
authors.forename: D A R H
authors.initials: DA
authors.lastname: Grootenboers
authors.affiliation: Reinier de Graaf Hospital, Department of Medical Oncology, Delft, the Netherlands.
authors.forename: A J E
authors.initials: AJ
authors.lastname: Vulink
authors.affiliation: Leiden University Medical Centre, Department of Radiation Oncology, Leiden, the Netherlands.
authors.forename: C A M
authors.initials: CA
authors.lastname: Marijnen
authors.affiliation: Leiden University Medical Centre, Department of Radiation Oncology, Leiden, the Netherlands.
authors.forename: K J
authors.initials: KJ
authors.lastname: Neelis
mesh_terms: D000230:Adenocarcinoma / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D016190:Carboplatin / Q000008:administration & dosage*; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000628:therapy*; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin; D017239:Paclitaxel
keywords: adverse effects; carboplatin; chemoradiotherapy; esophageal cancer; paclitaxel