Pre-operative Carboplatin/Paclitaxel Versus 5-Fluorouracil (5-FU)-based Chemoradiotherapy for Older Adults With Esophageal Cancer

Anticancer Res. 2022 Jan;42(1):59-66. doi: 10.21873/anticanres.15457.

Abstract

Background/aim: This study aimed to compare the efficacy and tolerability of pre-operative platinum/5-fluorouracil (P5F) and carboplatin/paclitaxel (CP), in combination with radiation therapy in older adults with locally advanced, stage I-III esophageal cancer.

Patients and methods: We retrospectively reviewed 51 patients aged ≥70 years who underwent chemoradiotherapy followed by esophagectomy for stage I-III esophageal cancer between 2008 and 2018. Pathological complete response (pCR) and survival rates were compared across the two chemotherapy regimen arms.

Results: Treatment completion (p=0.28), pCR (p=0.89), and partial response rates were similar across both chemotherapy groups. Overall survival (OS) and disease-free survival (DFS) were similar across both groups with HR=0.80 (p=0.62) and HR=0.72 (p=0.72) respectively.

Conclusion: The lesser toxic CP regimen may be used in older patients with locally advanced esophageal cancer, with tumor response and survival rates similar to P5F chemotherapy.

Keywords: Esophageal cancer; carboplatin/paclitaxel; geriatric oncology; platinum/5-fluouracil; trimodality therapy.

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carboplatin / pharmacology
  • Carboplatin / therapeutic use*
  • Chemoradiotherapy / methods*
  • Esophageal Neoplasms / drug therapy*
  • Fluorouracil / pharmacology
  • Fluorouracil / therapeutic use*
  • Humans
  • Paclitaxel / pharmacology
  • Paclitaxel / therapeutic use*
  • Retrospective Studies

Substances

  • Carboplatin
  • Paclitaxel
  • Fluorouracil