According to results from a recent multicenter clinical study, definitive chemoradiation tharapy with carboplatin and paclitaxel for patients with esophageal cancer demonstrated similar overall survival (OS) and disease-free survival (DFS) to those treated with cisplatin and 5-fluorouracil (5-FU). In addition, the treatment with carboplatin and paclitaxel showed significantly lower toxicity rates. The treatment with cisplatin/5-FU was the standard treatment for patients with esophageal cancer who were not eligible for surgery.
The study, which ran from 1996 to 2008, involved 102 patients at 5 centers in the Netherlands. 55 of the patients received carboplatin (area under the curve 2) and paclitaxel (50 mg/m2), and the other 47 received cisplatin (75 mg/m2) and 5-FU (1g/m2). 82% of the carboplatin/paclitaxel treated group completed the study, and 57% in the cisplatin/5-FU treated group.
The results indicated that the difference of OS was not statistically significant between those two groups: 13.8 months in the carboplatin/paclitaxel group and 16.1 months in the cisplatin/5-FU group. Median DFS was also similar between the groups, which were 9.7 months in the carboplatin/paclitaxel group and 11.1 months in the cisplatin/5-FU group.
The clinical T-stage was higher among patients in the carboplatin/paclitaxel group (P=.008), however, results of a univariate analysis showed clinical T-stage was not associated with OS (P=.250) or DFS (P=.201). The cisplatin/5-FU group experienced significantly higher rates of grade ≥3 hematologic and nonhematological adverse events compared to the carboplatin/paclitaxel group, which were 19% vs. 4% and 38% vs. 18% respectively.
“Toxicity rates were lower in the carboplatin/paclitaxel group, together with higher treatment compliance,” wrote the researchers. “Carboplatin/paclitaxel as an alternative treatment of cisplatin/5-FU is a good candidate regimen for further evaluation.”