Abstract
This study was performed to evaluated the efficacy and safety of continuous infusional paclitaxel and 5-Fu as first-line chemotherapy in patients with advanced esophageal squamous cell cancer (ESCC). A total of 22 patients with advanced esophageal squamous cell cancer with no indications for surgery and radiation therapy, or recurrent patients were enrolled from October 2008 to November 2010. All were treated with PTX 20 mg/m2 was administered through a 16 hours continuous intravenous infusion on days 1 to 3, 8 and 9. DDP 3.75 mg/m2 was given on days 1 to 4 and 8 to 11, continuous infusional 5-FU over 24-hours on days 1 to 5 and 8 to 12 at a dose of 375 mg/m2, and folacin 60 mg orally synchronized with 5-Fu. The treatment was repeated every 21 days for at least two cycles. 22 cases of all enrolled patients could be evaluated for the effect of treatment: 2 cases were CR, 9 cases PR, 5 cases SD and 2 cases PD, giving an overall response rate of 68.2% (15/22). The median time to progression was 7.0 months. The adverse reactions related to chemotherapy were tolerable; the most common toxic effects were marrow depression, alopecia, and fatigue. Low-dose continuous infusional PTX over 16-hours and 5-fu over 24-hours is a promising regimen with good tolerability in treating patients with advanced esophageal squamous cell cancer.
Highlights
Esophageal squamous cell carcinoma (ESCC) in China is the fourth most common cancer
A total of 22 patients with advanced esophageal squamous cell cancer with no indications for surgery and radiation therapy, or recurrent patients were enrolled from October 2008 to November 2010
DDP 3.75 mg/m2 was given on days 1 to 4 and 8 to 11, continuous infusional 5-FU over 24-hours on days 1 to 5 and 8 to 12 at a dose of 375 mg/m2, and folacin 60 mg orally synchronized with 5 fluorouracil (5-Fu)
Summary
Esophageal squamous cell carcinoma (ESCC) in China is the fourth most common cancer. ESCC is usually diagnosed at advanced stage, and chemotherapy is a main treatment for ESCC. First-line chemotherapy includes cisplatin (DDP), 5 fluorouracil (5-Fu), paclitaxel (PTX) with response rates (RR) ranging from 40%-60%. One- , 3- and 5-year survival rates after diagnosis were about 50%, 20% and 10%, respectively, with a median survival time (OS) about 12 months. Effective and well-tolerated chemotherapy is considered to be a modality to prolong OS and to improve quality of life. Reasonable chemotherapeutic modification includes dose and exposure time adjustment of the conventional regimen administered
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