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Metronomic weekly paclitaxel in advanced unresectable esophageal cancer.
Indian J Cancer ; 2013 Apr-June; 50(2): 128-134
Article in English | IMSEAR | ID: sea-148637
ABSTRACT
CONTEXT Advanced esophageal cancer is aggressive with an expected median survival of 6‑7 months. Combination chemotherapy regimens provide effective palliation, but result in substantial toxicity. MATERIALS AND

METHODS:

Retrospective analysis of prospectively collected data of patients with advanced esophageal cancer, not amenable to definitive intent therapy who were treated with intravenous weekly paclitaxel.

RESULTS:

Between October 2010 and August 2011, 51 patients were included. Median age was 56 years, with a male female ratio of 2.91. 29% were mid esophageal and 55% were lower third and gastroesophageal junction tumors. 65% of the tumors had squamous histology. Performance status was > 2 in 45%. 61% patients had received prior therapy, either definitive or palliative. 51% patients were platinum‑pre‑treated and 29% had received prior 3 weekly paclitaxel. 76% patients had distant metastases. Median number of cycles of weekly paclitaxel delivered was 11. 71% of patients had improvement in dysphagia, with a median time to symptom improvement of 9 days. In 72% patients, the feeding nasogastric tube could be removed. Overall response rate was 49% (complete remission 4%, partial remission 45%, stable disease 13%). Median progression free survival was 4.7 months (confidence interval [95% CI 3.7‑5.7 months]) and median overall survival was 7.5 months (95% CI 3.1‑11.8 months). Histopathology, performance status and pre‑treatment albumin significantly affected survival. The most common grade 3/4 toxicities included hyponatremia (14%), fatigue (16%), diarrhea (12%), anemia (31%), neutropenia (10%) and febrile neutropenia (4%).

CONCLUSIONS:

Metronomic weekly paclitaxel chemotherapy may provide palliative benefit in advanced unresectable metastatic esophageal cancer with minimal toxicity.
Subject(s)

Full text: Available Index: IMSEAR (South-East Asia) Main subject: Aged / Female / Humans / Male / Esophageal Neoplasms / Carcinoma, Squamous Cell / Cisplatin / Paclitaxel / Disease-Free Survival / Adult Language: English Journal: Indian J Cancer Year: 2013 Type: Article

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Full text: Available Index: IMSEAR (South-East Asia) Main subject: Aged / Female / Humans / Male / Esophageal Neoplasms / Carcinoma, Squamous Cell / Cisplatin / Paclitaxel / Disease-Free Survival / Adult Language: English Journal: Indian J Cancer Year: 2013 Type: Article