Open Access

ARTICLE

Clinical Outcome in Definitive Concurrent Chemoradiation With Weekly Paclitaxel and Carboplatin for Locally Advanced Esophageal and Junctional Cancer

Vanita Noronha^*, Kumar Prabhash^*, Amit Joshi^*, Vijay Maruti Patil^*, Sanjay Talole^†, Dipti Nakti^*, Arvind Sahu^*, Srushti Shah^‡, Sarbani Ghosh-Laskar^§, Prachi S. Patil^¶, Shaesta A. Mehta^¶, Nirmala Jambhekar^#, Abhishek Mahajan^**, Nilendu Purandare^††

* Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
† Department of Epidemiology and Biostatistics, Tata Memorial Hospital, Mumbai, India
‡ Clinical Research Secretariat, Tata Memorial Hospital, Mumbai, India
§ Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India
¶ Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Mumbai, India
# Department of Pathology, Tata Memorial Hospital, Mumbai, India
** Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, India
†† Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, India

Oncology Research 2015, 23(4), 183-195. https://doi.org/10.3727/096504016X14537290676865

Abstract

There are little data on the efficacy and safety of taxane/platinum with definitive radiotherapy (RT) for esophageal/GEJ cancer. This article is a retrospective analysis of patients who received weekly paclitaxel 50 mg/ m2 and carboplatin AUC 2 with radical definitive RT for locally advanced esophageal/GEJ cancer. Between February 2011 and July 2014, 179 patients were included. The median age was 54 years. Ninety-two percent of patients had squamous histology. Mean RT dose was 58.7 Gy in 32 fractions over 53 days, with mean of six chemotherapy cycles. Fifty-six percent of patients developed ³grade 3 acute toxicities, commonly febrile neutropenia (12%) and infection (11%); ³grade 3 laboratory abnormalities included hyponatremia (38%), leukopenia (49%), neutropenia (27%), and anemia (16%). Twelve percent of patients developed ³grade 3 chronic toxicity. Fatal toxicities included six during CRT, eight within 30 days of completing CRT, and three chronic. Radiologic response was 49% (CR 5.6%, PR 43%). Follow-up endoscopy showed remission in 53% and residual disease in 14%. At a median follow-up of 28 months, median PFS was 11 months (95% CI: 8–13.9), median OS was 19 months (95% CI: 15.4–22.6), and estimated 1-year, 2-year, and 3-year survivals were 70%, 47%, and 39%, respectively. Weekly paclitaxel–carboplatin concurrently with definitive RT is efficacious with manageable toxicity. [The trial was registered with the Clinical Trials Registry-India (CTRI), registration number: CTRI/2014/07/004776.]

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