Open AccessAnalysis of pathological complete response rates with paclitaxel‐based regimens in trimodality therapy for esophageal cancer
Author(s) -
Boggs D. H.,
Tarabolous C.,
Morris C. G.,
Hanna A.,
Burrows W.,
Horiba N.,
Suntharalingam M.
Publication year - 2015
Publication title -
diseases of the esophagus
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 63
eISSN - 1442-2050
pISSN - 1120-8694
DOI - 10.1111/dote.12243
Subject(s) - medicine , taxane , radiation therapy , paclitaxel , esophageal cancer , chemoradiotherapy , esophagectomy , oncology , chemotherapy , cancer , stage (stratigraphy) , gastroenterology , surgery , breast cancer , paleontology , biology
Summary The study aimed to examine whether omission of 5‐fluorouracil (5‐ FU )‐containing chemotherapy alters pathological complete response rates in patients receiving trimodality therapy for locally advanced esophageal cancer. A total of 159 patients were identified. One hundred twenty‐nine patients received platinum/5‐ FU concurrently with radiotherapy, and 30 received taxane/platinum‐containing chemoradiotherapy prior to esophagectomy. Patients were staged using the 2002 A merican J oint C ommittee on C ancer staging system. Patients were matched between chemotherapeutic groups, with no significant demographic or clinical differences other than T stage (14% T 2 in the 5‐ FU group; no T 2 in the platinum/taxane group) and radiotherapy technique (8.5% received intensity‐modulated radiotherapy in the 5‐ FU group; 60% in the platinum/taxane group). Pathological complete response rates for 5‐ FU and platinum/taxane‐based groups were not significantly different (45% and 30%, respectively; P = 0.1548). Five‐year overall survival and progression‐free survival were not statistically different between the two groups. Significant predictors of pathological complete response included N stage (56% N 0 and 33% N 1; P = 0.0083), histology (37% adenocarcinoma and 59% squamous cell; P = 0.0123), tumor location (39% distal and 59% proximal/mid; P = 0.048), gastroesophageal junction involvement (33% involved and 55% uninvolved; P = 0.005), and radiotherapy end‐to‐surgery interval (50% < 55 days and 34% ≥ 55 days; P = 0.04). Grades 3–4 hematological toxicity was higher in the 5‐ FU group (36%) than in the paclitaxel‐containing therapy group (17%; P = 0.0484). Use of paclitaxel‐containing chemoradiotherapy did not result in inferior pathological complete response, overall survival, or progression‐free survival rates, and resulted in less hematological toxicity than 5‐ FU treatment.