P-0134 - A prospective institutional study of chemoradiotherapy with weekly docetaxel for unresectable locally advanced esophageal carcinoma

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Anti-Cancer Agents & Biologic Therapy
Oesophageal Cancer
Surgery and/or Radiotherapy of Cancer
Presenter Mukesh Singhal
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors M. Singhal, N. Sharma, H. Kumar, A. Sharma, M. Bardia, A. Kapoor, P. Bagri, D. Singh, S. Narayan, G. Singh, S. Maharia, S. Jakhar, S. Beniwal, P. Kumari
  • Acharya Tulsi Regional Cancer Treatment and Research Center, Bikaner/IN

Abstract

Introduction

The present standard modality of treatment of patients with unresectable or inoperable esophageal carcinoma is definitive chemoradiotherapy. Cisplatin and 5-fluorouracil are used as radiosensitizers as concurrent chemotherapeutic agents. However, significant toxicities have been observed. The efficacy and safety of concurrent chemoradiotherapy with weekly docetaxel for head and neck squamous cell carcinoma and non-small cell lung cancer have already been recognized. We conducted a prospective institutional study of chemoradiotherapy with weekly docetaxel for unresectable locally advanced esophageal carcinoma.

Methods

26 patients with unresectable locally advanced esophageal squamous cell carcinoma having a T4 tumor and/or distant lymph node metastasis were enrolled in this study. Docetaxel was administered concurrently with 60 Gy of radiation by drip infusion at a dose of 10 mg/m2 for an hour weekly and 6 times in total. Tumor response rate and overall survival was taken as primary end point. Secondary end point was treatment related toxicities and compliance of the patient. Kaplan Meier method was used to estimate overall survival (OS) and compared using the log rank test, breslow and tarone-ware test. All statistical calculations were performed using SPSS for windows, version 20.0 (Armonk, New York, IBM Corp).

Results

All 26 patients completed the treatment schedule without any suspension. Seven patients (26.92%) achieved complete response, and eleven patients (42.3%) achieved partial response. The other eight patients (30.76%) had progressive disease (PD). PD in the patients developed because of progression of the primary lesion, development of lung metastases or development of bone metastases. The response rate was 69%. The median survival time was 18.3 months and the 2-year survival rate was 41.7%. Grade 3/4 hematological and biochemical toxicities did not occur.

Conclusion

Concurrent chemoradiotherapy with weekly low dose docetaxel is a safe and effective treatment regimen for unresectable locally advanced esophageal squamous cell carcinoma. We expect that this protocol of chemoradiotherapy may be one of the choices of treatment substituting the regimen with cisplatin and 5-fluorouracil, particularly for the patients for whom chemotherapy with cisplatin and fluorouracil is considered inappropriate because of concomitant renal dysfunction or prior failure of systemic chemotherapy with cisplatin and 5-fluorouracil.