Objective: To evaluate the efficacy and safety of a 24-hour continuous infusion of paclitaxel in combination with oxaliplatin in the treatment of advanced esophageal cancer.
Methods: A total of 43 subjects with III-IV stage advanced esophageal cancer were enrolled from March 2008 to June 2009. There were squamous cell carcinoma (n = 32) and adenocarcinoma (n = 11). Among them, 36 patients had no prior chemotherapy, 7 patients received adjuvant chemotherapy and 4 accepted taxane-based regiments. The median age was 56 years old. All patients were treated with paclitaxel 175 mg/m(2) by a 24-hour continuous infusion, oxaliplatin 130 mg/m(2) at Day 2, 3 weeks as one cycle.
Results: Forty-three patients completed 130 cycles (median: 3). And the efficacy and safety of 41 patients could be evaluated. According to the WHO standard, there were complete response (CR) (n = 4), partial response (PR) (n = 16), stable disease (SD) (n = 9), progressive disease (PD) (n = 12) and response rate (RR) 48.7%. Thirty cases of squamous cell carcinoma could be evaluated, CR 4, PR 14, SD 4, PD 8, RR 60.0%; Adenocarcinoma CR 0, PR 2, SD 5, PD 4, RR 18.2%. Statistical test show that RR of squamous was higher than that of adenocarcinoma (P < 0.05). The most common toxicity was hematological. Grade III-IV neutropenia was seen in 16 patients (41.4%), alopecia 60.9%, vomiting 26.8%, neuropathy 22% and myalgia 19.5%. Most of them were of Grade I-II.
Conclusions: The efficacy of a 24-hour continuous infusion of paclitaxel plus oxaliplatin in the treatment of advanced esophageal cancer is excellent. All toxicities are well tolerated. So this protocol may be considered a main regimen in the treatment of advanced esophageal cancer.