Definitive concurrent chemoradiotherapy with paclitaxel plus carboplatin is superior to cisplatin plus 5-fluorouracil in patients with inoperable esophageal squamous cell carcinoma using retrospective, real-world evidence

Jason Chia Hsun Hsieh, Pin Chun Chiang, Tsung Min Hung, Yin Kai Chao, Yung Chia Kuo, Chih Tsung Wen, Po Jung Su, Meng Ting Peng, Huan Wu Chen, Hui Ling Liu, Hsien Kun Chang*, Min Hsien Wu*, Hung Ming Wang*

*Corresponding author for this work

Research output: Contribution to journalJournal Letter peer-review

6 Scopus citations

Abstract

Background: The optimal definitive chemotherapy regimen during concurrent chemoradiotherapy (CRT) for patients with advanced esophageal squamous cell carcinoma (ESCC) remains unclear because of conflicting evidence. This study aimed to compare the effectiveness of taxane-based chemotherapy with that of conventional cisplatin plus 5-fluorouracil (PF) as the chemotherapy regimen in definitive CRT for ESCC. Patients and Methods: This retrospective study included patients with ESCC who received paclitaxel plus carboplatin (PC) or PF during definitive CRT between May 2012 and February 2015 in a medical center in Taiwan. Survival outcomes were compared after adjustment for risk factors. Results: Overall, 229 patients were evaluated. Patients in the PC group had an objective response rate of 71.1% compared with the 51.4% of the PF group (p = 0.016). The PC group showed a significantly longer progression-free survival (PFS, p = 0.002) and overall survival (OS, p = 0.019) than the PF group. Salvage surgery also helped prolong both the PFS and OS (p < 0001). Sex (male vs. female, HR, 1.831; 95% CI, 1.016–3.303), clinical stage (HR, 1.282; 95% CI, 1.069–1.537), accumulative radiation dose (≥41.4 Gy vs. <41.4 Gy; HR, 0.640; 95% CI, 0.413–0.993), salvage surgery (yes vs. no, HR: 0.412, 95% CI: 0.298–0.570), and regimen (PF vs. PC; HR, 1.514; 95% CI, 1.109–2.067) were independent prognostic factors for cancer mortality. Conclusion: Compared with the PF regimen, the PC regimen for definitive CRT yielded significantly increased response rates and longer survival times; therefore, the PC regimen may be preferable for chemotherapy for definitive CRT in patients with advanced ESCC.

Original languageEnglish
Pages (from-to)8300-8309
Number of pages10
JournalCancer Medicine
Volume10
Issue number23
DOIs
StatePublished - 12 2021

Bibliographical note

Publisher Copyright:
© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Keywords

  • 5-fluorouracil
  • carboplatin
  • cisplatin
  • definitive chemoradiotherapy
  • esophageal squamous cell carcinoma
  • paclitaxel

Fingerprint

Dive into the research topics of 'Definitive concurrent chemoradiotherapy with paclitaxel plus carboplatin is superior to cisplatin plus 5-fluorouracil in patients with inoperable esophageal squamous cell carcinoma using retrospective, real-world evidence'. Together they form a unique fingerprint.

Cite this