Prolonged chemotherapy for localised squamous carcinoma of the oesophagus

Ajani, Jaffer A.; Ryan, Bernadette M.; Rich, Tyvin A.; McMurtrey, Marion J.; Roth, Jack A.; DeCaro, Louis F.; Levin, Bernard; Mountain, Clifton F.

doi:10.1016/0959-8049(92)90140-w

Cited by 64 publications

(21 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cisplatin/5-fluorouracil is considered the standard treatment for carcinoma of the oesophagus (Ajani et al, 1992;Coia, 1994). Haematological toxicity of this combination occurred in 34% (Hilgenberg et al, 1988).…”

Section: Discussionmentioning

confidence: 99%

Chemotherapy with cisplatin and paclitaxel in patients with locally advanced, recurrent or metastatic oesophageal cancer

Petrasch

Welt²,

Reinacher³

et al. 1998

Br J Cancer

View full text Add to dashboard Cite

Summary Single-agent therapy with paclitaxel is effective against both squamous cell carcinoma and adenocarcinoma of the oesophagus. However, only limited data are available on the combination of paclitaxel with other cytotoxic drugs in this entity. Patients with unresectable stage l1l, recurrent or metastatic tumours were treated in a multicentre setting with paclitaxel 90 mg m-2 given over 3 h intravenously, followed by cisplatin 50 mg m-2. The courses were repeated every 14 days. Twenty patients with squamous cell carcinoma or adenocarcinoma of the oesophagus were evaluable for response. The overall remission rate was 40% (8/20), including 15% (3/20) clinically complete responses. Clinical benefit response, defined as relief of dysphagia and/or significant gain in weight, was achieved in 70% of the patients. Neutropenia of CTC grade 3 occurred only in 10% of the patients; no grade 4 neutropenia and no severe thrombocytopenia was encountered. CTC grade 4 neurotoxicity was seen in 5% of patients. Cisplatin/paclitaxel administered every 14 days, was effective in patients with poor prognosis oesophageal cancer and toxicity was acceptable.Keywords: paclitaxel; cisplatin; oesophageal cancer Several chemotherapeutic agents have been adequately investigated in patients with oesophageal cancer, predominantly with squamous cell histology. The most active drugs, with a response rate of at least 20%, are bleomycin, cisplatin, 5-fluorouracil, methotrexate, mitomycin-C and vindesine (Ajani, 1994). Currently, the combination of 5-fluorouracil and cisplatin is considered th6 standard treatment for squamous cell carcinoma of the oesophagus, with 50% of the patients responding to the treatment. Paclitaxel has demonstrated significant clinical activity against a variety of tumours. After a 24-h continuous infusion of 250 mg m-2 paclitaxel, Ajani et al (1994) achieved either a complete or partial response in 32% of oesophageal cancer patients.Only limited data are available on the combination of paclitaxel with other cytotoxic drugs in oesophageal cancer. Ajani et al (1995) have reported the preliminary results of a regimen combining paclitaxel with cisplatin and a continuous infusion of 5-fluorouracil. The overall remission rate was 44%. Gelmon and colleagues (Gelmon et al, 1996) established the maximum tolerated dose of paclitaxel in combination with cisplatin, repeated biweekly, in patients with metastatic breast cancer. The objective of our trial was to evaluate the response rate and the toxic effects of cisplatin/paclitaxel, repeated biweekly, in previously untreated patients with unresectable, recurrent or metastatic carcinoma of the oesophagus.

show abstract

Section: Discussionmentioning

confidence: 99%

Chemotherapy with cisplatin and paclitaxel in patients with locally advanced, recurrent or metastatic oesophageal cancer

Petrasch

Welt²,

Reinacher³

et al. 1998

Br J Cancer

View full text Add to dashboard Cite

show abstract

“…The most commonly used agents are cisplatin and fluorouracil, although some investigators incorporated vinca alkaloids or taxanes into their regimens. Clinical response rates of 40%-65%, pathological complete responses rates of 0%-10%, and resectability rates of 40%-80% were documented in some trials [31][32][33][34][35][36][37][38][39][40][41][42]. Median survival of these patients was reported to be 18-28 months [31][32][33][34][35][36][37][38][39][40][41][42][43].…”

Section: Neoadjuvant Chemotherapy With Surgery Versus Surgery Alonementioning

confidence: 99%

Multiple Management Modalities in Esophageal Cancer: Combined Modality Management Approaches

et al. 2004

View full text Add to dashboard Cite

The overall success rate nationally in treating esophageal carcinomas remains poor, with over 90% of patients succumbing to the disease. In part I of this twopart series, we explored epidemiology, presentation and progression, work-up, and surgical approaches. In part II, we explore the promising suggestions of integrating chemotherapy and radiation therapy into the multimodal management of esophageal cancers.Alternative approaches to resection alone have been sought because of the overall poor survival rates of esophageal cancer patients, with failures occurring both localregionally and distantly. Concomitant chemotherapy and radiation therapy (XRT) have been shown, by randomized trial, to be more effective than XRT alone in treating unresectable esophageal cancers and also have shown promise as a neoadjuvant treatment when combined with surgery in the multimodal treatment of this disease. Various studies have also addressed issues such as preoperative chemotherapy, radiation dose escalation, chemotherapy/XRT as a definitive treatment versus use as a surgical adjuvant, and alternative chemotherapy regimens. There are suggestions of some progress, but this remains a difficult problem area in which management is continuing to evolve. The Oncologist 2004;9:147-159 The Oncologist 2004;9:147-159 www.TheOncologist.com Correspondence: Richard H. Matthews, M.D., Ph.D., Department of Radiation Oncology, Beth Israel/Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, Massachusetts 02215, USA. Telephone: 617-232-9500, ext 4457 or ext 5628; Fax: 617-524-0643; e-mail: RHMatthews@comcast.net Received August 15, 2003; accepted for publication November 19, 2003. ©AlphaMed Press 1083-7159/2004 INTRODUCTIONThe long-term outlook for esophageal cancer patients, traditionally treated by surgical approaches, has been bleak.

show abstract

“…In these patients, definitive chemotherapy is the standard treatment. The combination of cisplatin plus 5-fluorouracil (CF) has been regarded as one of the standard regimens worldwide for metastatic SCCE [3-5]. The overall response rate, however, of patients who undergo CF regimens is only 30% [4-8], therefore this regimen may be lacking power.…”

Section: Introductionmentioning

confidence: 99%

Phase I/II Trial of Chemotherapy with Docetaxel, Cisplatin, and S-1 for Unresectable Advanced Squamous Cell Carcinoma of the Esophagus

et al. 2018

View full text Add to dashboard Cite

Our previous trial with a docetaxel, cisplatin, and 5-fluorouracil (DCF) regimen showed high response rates in metastatic squamous cell carcinoma of the esophagus (SCCE). The observed increased toxicity of the DCF regimen, however, was clinically harmful. S-1, an oral anticancer drug, has been approved as a combination therapy for SCCE, and alternate-day regimen with S-1 has shown lower levels of toxicity. This prospective single-center phase I/II trial examines the efficacy and toxicity of a combination of docetaxel, cisplatin, and an alternate-day regimen of S-1 (modified DCS) for patients with metastatic SCCE. We use a two-stage design. Phase I is undertaken to determine the maximum tolerated dose and the recommended dose. The phase I trial adopts a three-patient cohort with escalating dose study design. In the phase II trial, the primary endpoint is the assessment of the overall response rate (Response Evaluation Criteria in Solid Tumors 1.1). The secondary endpoints are the evaluation of drug-related toxicity (National Cancer Institute Common Toxicity Criteria 4.0), overall survival, and progression-free survival. Fifty patients with metastatic SCCE participate in the phase II section. This study protocol is the first to test the effects of the modified DCS regimen for metastatic SCCE.

show abstract

Prolonged chemotherapy for localised squamous carcinoma of the oesophagus

Cited by 64 publications

References 32 publications

Chemotherapy with cisplatin and paclitaxel in patients with locally advanced, recurrent or metastatic oesophageal cancer

Chemotherapy with cisplatin and paclitaxel in patients with locally advanced, recurrent or metastatic oesophageal cancer

Multiple Management Modalities in Esophageal Cancer: Combined Modality Management Approaches

Phase I/II Trial of Chemotherapy with Docetaxel, Cisplatin, and S-1 for Unresectable Advanced Squamous Cell Carcinoma of the Esophagus

Contact Info

Product

Resources

About