Short report of esophageal Cancer.docx

1、Short report of esophageal CancerA phase I/II trial of paclitaxel and oxaliplatin combined with radiotherapy in patients with localized esophageal cancerAbstractPurpose: To assess the efficacy and toxicity of paclitaxel and oxaliplatin combined with radiotherapy in patients with localized esophageal

2、 cancer.Methods: Thirty-four patients with localized esophageal cancer were treated with paclitaxel 135mg/ mand oxaliplatin 75mg/ mon days 1 and 29 of a 29-day cycle combined with 60Gy/30F radiotherapy. Patients with localized esophageal cancer were eligible for the trial.Results: Thirty-one patient

3、s(31/34) with localized esophageal cancer complete the combined-modality therapy who had the following characteristics: median age 66 years (range 3980); Karnofsky performance status70%. There were 32 patients (94.12%) with squamous-cell carcinoma of the esophagus and 1 patient (2.94%) had an adenoc

4、arcinoma and 1 patient (2.94%) had an adenosqumous carcinoma. NCI grade 4 toxicity (leukopenia) was observed in five patients. Non-haematological toxicity consisted mainly of alopecia and grade 1/2 radiation esophagitis and bronchitis and gastrointestinal reaction. The overall response rate was 93.5

5、% (29/31) with 3 patients (9.68%) achieving complete response. Median overall survival time was 14.5 months (range 2.482) and median time to progression or distant metastasis was 22.17 months (range ? ?). There were no treatment-related deathsConclusion: This regimen demonstrates efficacy and well t

6、olerance of toxicity in patients with localized esophageal cancer and may be a treatment option for this population in a near future.Keywords: Oxaliplatin Paclitaxel radiotherapy chemotherapylocalized esophageal cancerIntroduction:(japan)Esophageal cancer constitutes a global health burden, with bet

7、ween 400,000 and 500,000 new cases diagnosed annually 1,2. It is the eighth most common cancer worldwide and ranks sixth as a cause of cancer death2 .The overall incidence of esophageal cancer appears to be rising, principally due to an increase in the incidence of adenocarcinoma of the lower third

8、of the esophagus in western countries3-5. This may be due to increasing rates of obesity, gastro-esophageal reflux, and Barretts esophagus in those countries. (奥沙利铂+紫衫模板)About 90% of all patients diagnosed with esophageal cancer will die as a consequence of this disease. Besides the predominantly la

9、te diagnosis, another reason for this poor prognosis of this tumour is the limited effectiveness of systemic therapy6. (奥沙利铂+紫衫模板)Even if there is no established standard chemoradiationtherapy, cisplatin+5-Fu combined with radiotherapy are accepted as a standard of care7,8. Oxaliplatin is a third-ge

10、neration platinum compound with a favourable toxicity profile as compared to cisplatin3,4.(china)Paclitaxel, a new broad-spectrum cytotoxic antineoplastic is now widely used for the treatment of ovarian cancer, breast cancer, and lung cancer, and recently, has shown some promising responses against

11、digestive tract cancer. Multiple Phase III studies have demonstrated that Taxanes have significant activity in patients with locally advanced and metastatic esophageal cancer2,5-9.As a single agent, paclitaxel has been shown to achieve a response rate of 32% in esophageal cancer and gastroesophageal

12、 junction cancer10.(Japan)Ilson et al. 21 showed that paclitaxel 80 mg/madministered by weekly 1-h infusion was well tolerated and showed modest activity in advanced esophageal cancer. A phase I trial in Japan studied weekly paclitaxel for solid tumors, in which paclitaxel was administered weekly ov

13、er 1 h for 6 weeks followed by a 1-week break. Paclitaxel dose was escalated from 80120 mg/ m with no dose limiting toxicity observed. (Peripheral neuropathy developed in all six patients who received 120 mg/m/week and four patients discontinued treatment22. A dose of 120 mg/mwas therefore set as th

14、e maximum acceptable dose (MAD) and 100 mg/ mrecommended for phase II studies). We therefore evaluated the efficacy and tolerability of paclitaxel 135 mg/mand oxaliplatin 75mg/mcombined with 60Gy/30F radiotherapy in patients with localized esophageal cancer.(证据不足).Patients and MethodsThis phase I/II

15、 study was conducted at 1 st Hospital Affiliated to Wenzhou Medical College. Eligible patients were adults of at least 18 years of age (no upper limit) with histologically confirmed squamous cell carcinoma, adenocarcinoma or adenosquamous carcinoma of the esophagus. (RTOG9405)Karnofsky performance s

16、tatus of 70 or greater, (奥沙利铂+紫衫模板) Adequately defined hematological, renal, and hepatic function were required hemoglobin90 g/L, neutrophils1.510 9/L, platelets count10010 9/L, creatinine1.5 times upper limit of normal value (ULN), total serum bilirubin levl1.5 ULN and alanine aminotransferase (ALT)2.5 ULN, bronchoscopy to exclude a tracheoesophageal fistula if the lesion was less than 30 cm from the incisors, chest