Chemoradiation regimens conferred similar outcomes in esophageal cancer

Patients with esophageal cancer who underwent definitive chemoradiation with carboplatin and paclitaxel demonstrated similar OS and DFS as those treated with cisplatin plus 5-fluorouracil, according to results of a multicenter study.

However, patients treated with carboplatin and paclitaxel demonstrated significantly lower toxicity rates, researchers wrote.

Definitive chemoradiation with cisplatin and 5-fluorouracil (5-FU) is the standard chemotherapy regimen for patients with esophageal cancer who are not eligible for surgery. However, carboplatin plus paclitaxel has become more common, according to background information in the study.

Researchers evaluated 102 patients treated at five centers in the Netherlands from 1996 to 2008 to compare survival outcomes and toxicities associated with both regimens.

Forty-seven patients were treated with 75 mg/m² cisplatin and 1g/m² 5-FU. The other 55 patients received carboplatin area under the curve 2 and 50 mg/m² paclitaxel.

More patients completed the carboplatin/paclitaxel regimen (82% vs. 57%; P=.010).

Median OS was 16.1 months in the cisplatin/5-FU group and 13.8 months in the carboplatin/paclitaxel group, a difference that was not statistically significant (HR=0.97; 95% CI, 0.62-1.51).

Median DFS was 11.1 months in the cisplatin/5-FU group and 9.7 months in the carboplatin/paclitaxel group (HR=0.93; 95% CI, 0.60-1.45).

Although clinical T-stage was higher among those in the carboplatin/paclitaxel group (P=.008), results of a univariate analysis showed clinical T-stage was not associated with OS (P=.250) or DFS (P=.201).

Patients treated with cisplatin/5-FU demonstrated significantly higher rates of grade ≥3 hematologic (19% vs. 4%) and nonhematological adverse events (38% vs. 18%) than those treated with carboplatin/paclitaxel (P=.001).

“Toxicity rates were lower in the carboplatin/paclitaxel group, together with higher treatment compliance,” the researchers wrote. “Carboplatin/paclitaxel as an alternative treatment of cisplatin/5-FU is a good candidate regimen for further evaluation.”

Disclosure: See the study for a full list of the researchers’ relevant financial disclosures.