Phase II study of neo-adjuvant chemotherapy with paclitaxel and cisplatin given every 2 weeks for patients with a resectable squamous cell carcinoma of the esophagus
BACKGROUND: We have previously reported a favourable response rate in patients with advanced esophageal cancer after treatment with a biweekly regimen of paclitaxel and cisplatin. In this study we investigate the feasibility and efficacy of this regimen in a neo-adjuvant setting. PATIENTS AND METHODS: Patients with resectable squamous cell carcinoma of the esophagus received paclit-axel 180 mg/m(2) and cisplatin 60 mg/m(2) every 2 weeks. Patients received three courses and responding patients received three additional courses; thereafter, patients were referred for surgery. Patient characteristics of 50 eligible patients were as follows: male, 60%; median age, 62 years (range 45-78); median World Health Organization performance status of 1 (range 0-2). RESULTS: Ninety-four per cent of patients received at least three courses of chemotherapy. Haematological toxicity consisted of National Cancer Institute-Common Toxicity Criteria grade 3 or 4 neutropenia in 71% of patients, with neutropenic fever occurring in only two patients (4%). The overall response rate was 59%. Pathological examination showed tumour-free margins in 38 patients. In seven patients no residual tumour was found. The median overall survival was 20 months and the 1- and 3-year survival rates were 68% and 30%, respectively. CONCLUSIONS: This dose-dense schedule of paclitaxel and cisplatin administered biweekly is well tolerated and the observed overall and complete response rates are promising.
|Aged, Antineoplastic Combined Chemotherapy Protocols/*therapeutic use, Carcinoma, Squamous Cell/*drug therapy/mortality/pathology/surgery, Chemotherapy, Adjuvant, Cisplatin/*administration & dosage, Comparative Study, Dose-Response Relationship, Drug, Drug Administration Schedule, Esophageal Neoplasms/*drug therapy/mortality/pathology/surgery, Esophagectomy/methods, Female, Humans, Infusions, Intravenous, Male, Middle aged, Neoadjuvant Therapy, Neoplasm Staging, Paclitaxel/*administration & dosage, Probability, Prognosis, Research Support, Non-U.S. Gov't, Survival Analysis, Treatment Outcome|
|Annals of Oncology|
|Organisation||Erasmus MC: University Medical Center Rotterdam|
Polee, M.B, Tilanus, H.W, Eskens, F.A.L.M, Hoekstra, R, van der Burg, M.E.L, Siersema, P.D, … van der Gaast, A. (2003). Phase II study of neo-adjuvant chemotherapy with paclitaxel and cisplatin given every 2 weeks for patients with a resectable squamous cell carcinoma of the esophagus. Annals of Oncology. Retrieved from http://hdl.handle.net/1765/10195