• Oncology Clinical Trials
• Radiation Therapy
• Radiology
• Gastrointestinal Cancers

• Oncology Clinical Trials
• Radiation Therapy
• Radiology
• Oncology
• Gastrointestinal Cancers

Neoadjuvant chemoradiation therapy (nCRT) with carboplatin/paclitaxel (PT) has similar perioperative outcomes as platinum/5-FU (PF) in patients with locally advanced esophageal cancer (LAEC) but may have less toxicity. Abigail Berman, MD, University of Pennsylvania, Philadelphia, Pennsylvania, USA, presented findings from a retrospective analysis of patients with LAEC who were treated from 2008 to 2013.

Current nCRT for LAEC consists of radiation with PF chemotherapy. However, PT may be a favorable chemotherapy combination with preoperative radiation. This study investigated whether nCRT with PT would result in better perioperative outcomes.

A total of 100 consecutive patients were assessed; criteria included stage II to IV LAEC with a European Cooperative Oncology Group performance status of 0 to 1. The median radiation dose was 50.4 cGy (range, 45 to 59.4 cGy); 51% of patients received PF while 49% received PT. Most patients had adenocarcinoma (93%) of the esophagus and were male (86%) with a median age of 65 (range, 29 to 78). Follow-up assessments were examined, and perioperative complications were categorized as composite toxicity (hospital readmission) or acute toxicities in the pulmonary, cardiac, and gastrointestinal systems.

There was no difference in overall survival in PF versus PT patients (76% vs 70%; P = .70). Pathologic complete response was similar in patients treated with PF and PT (24% vs 25%; P = .91). There were also comparable rates of locoregional recurrence (18% vs 10%; P = .28) and distant metastases (22% vs 18%; P = .65).

There were no significant differences in baseline characteristics between the 2 groups or in pulmonary, cardiac, or gastrointestinal complications. However, patients treated with PF were readmitted more often than patients treated with PT (42% vs 22%; P = .04).

This study showed that PT nCRT and PF nCRT have comparable effects on a variety of outcomes. The authors concluded that reduced readmission rates suggest that PT may produce less composite toxicity during nCRT of LAEC.

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