Document Detail


Induction cisplatin and paclitaxel followed by combination chemoradiotherapy with 5-fluorouracil, cisplatin, and paclitaxel before resection in localized esophageal cancer: a phase II report.
MedLine Citation:
PMID:  16418887     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Multimodality therapy for esophageal cancer holds promise for improving outcome in this lethal disease. On the basis of encouraging data from a phase I trial, we conducted a phase II study of preoperative chemotherapy, followed by concurrent chemoradiotherapy and surgery. METHODS: Patients with clinically staged resectable esophageal cancer were treated with induction cisplatin and paclitaxel, followed by 45 Gy of external beam radiation with concurrent infusional 5-fluorouracil and weekly cisplatin and paclitaxel. Four to eight weeks after multimodality induction, esophagectomy was performed in suitable patients. Study end points were survival, pathologic complete response, and toxicity. RESULTS: Twenty-one patients were enrolled with a median age of 58 years, and all patients were clinically staged II or III. Sixteen (76.2%) patients completed the trial, of whom four (25%) had a pathologic complete response. One patient died from postoperative complications. Grade 3 or 4 toxicity was observed in 76% of patients, and dose-limiting toxicity was seen in 6 of the first 14 patients, thus necessitating a planned dose reduction of paclitaxel. At a median follow-up of 30 months, 13 patients remain alive. The 2-year disease-specific survival for the study population was 78%. CONCLUSIONS: This regimen of multimodality therapy before resection resulted in an encouraging 2-year survival rate but a disappointing rate of pathologic complete response and was toxic, necessitating a predetermined paclitaxel dose reduction. The incorporation of taxanes into induction strategies for esophageal cancer seems promising, but the optimal schedule remains undefined.
Authors:
Leonard R Henry; Melvyn Goldberg; Walter Scott; Andre Konski; Neal J Meropol; Gary Freedman; Louis M Weiner; Perry Watts; Mary Beard; Susan McLaughlin; Jonathan D Cheng
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Publication Detail:
Type:  Clinical Trial, Phase II; Journal Article     Date:  2006-01-18
Journal Detail:
Title:  Annals of surgical oncology     Volume:  13     ISSN:  1068-9265     ISO Abbreviation:  Ann. Surg. Oncol.     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-01-30     Completed Date:  2006-05-11     Revised Date:  2007-07-18    
Medline Journal Info:
Nlm Unique ID:  9420840     Medline TA:  Ann Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  214-20     Citation Subset:  IM    
Affiliation:
Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, Pennsylvania 19111, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Antineoplastic Combined Chemotherapy Protocols / adverse effects,  therapeutic use*
Cisplatin / administration & dosage
Drug Administration Schedule
Esophageal Neoplasms / mortality,  pathology,  therapy*
Esophagectomy
Female
Fluorouracil / administration & dosage
Humans
Male
Middle Aged
Neoadjuvant Therapy / adverse effects,  methods*
Paclitaxel / administration & dosage
Postoperative Complications
Radiotherapy Dosage
Remission Induction
Survival Rate
Chemical
Reg. No./Substance:
15663-27-1/Cisplatin; 33069-62-4/Paclitaxel; 51-21-8/Fluorouracil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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