Preoperative Therapy with Concurrent Paclitaxel/Carboplatin/Infusional 5-FU and Radiation Therapy in Locoregional Esophageal Cancer

Abstract

This novel combined-modality regimen is highly active in the treatment of locoregional esophageal cancer, producing an actuarial 3-year survival of 41%. Although this preoperative regimen produced moderate acute toxicity, there were no treatment-related deaths and the large majority of patients were able to undergo subsequent esophageal resection. These results, obtained in a community-based setting and involving multiple surgeons, radiation oncologists, and medical oncologists, compare favorably with those of previous single-center and multicenter results. Further evaluation of novel combined-modality programs is warranted, as is the incorporation of epidermal growth factor receptor antagonists or other targeted agents.

Neoadjuvant continuous infusion of weekly 5-fluorouracil and escalating doses of oxaliplatin plus concurrent radiation in locally advanced oesophageal squamous cell carcinoma: results of a phase I/II trial

“…Therefore, intensification of the treatment regimen, for example, by performing a sequential application of a high-dose induction chemotherapy followed by radiochemotherapy, as investigated by Stahl et al (2005) could provide a better control of systemic disease. Also, addition of other chemotherapy drugs like taxanes may add some additional effectiveness (Meluch et al, 2003;van de Schoot et al, 2008).…”

Locally Advanced Esophageal Cancer

“…A pathologic complete response was seen in 38% of patients, with a median survival of 22 months and a 3-year survival of 41% (Meluch et al, 2003).…”

Antitumor activity of folate-targeted, paclitaxel-loaded polymeric micelles on a human esophageal EC9706 cancer cell line

“…8 Paclitaxel has been found to be efficacious in the treatment of esophageal cancer, with pathologic complete response rates ranging from 20% to 60%, but accompanied by increased systemic toxicity. [9][10][11][12][13] To date, paclitaxel-loaded polymeric micelles have received attention because of their nanoscale formulation and controlled release of paclitaxel, and have demonstrated significant antitumor activity in patients with metastatic breast, lung, and gastric cancer. When encapsulated into micelles, paclitaxel can reach a solid tumor site via the enhanced permeability and retention effect and maintain an effective therapeutic concentration for a longer period of time.…”