15143 Background: Neoadjuvant taxane based chemotherapy may improve response rate in patients with locally advanced esophageal cancer. We have evaluated paclitaxel based induction chemotherapy in patients with locally advanced esophageal cancer to determine its feasibility, clinical response, radiological and endoscopic response. Methods: etween November 2004 to October 2006, 30 patients were enrolled in this study. All patients were categorized as locally advanced esophageal cancer. They underwent CT scan chest and upper GI endoscopy before chemotherapy and 3 cycles after the chemotherapy. Chemotherapy included 3 cycles of paclitaxel (135 mg/m2 on day 1),5FU (500 mg/m2 on day 1,2,3) and cisplatin (25 mg/m2 on day 1,2,3) every 21 days. The main endpoint was response evaluation. Twenty one (70%) had squamous cell carcinoma and 9(30%) had adenocarcinoma. Median age was 44 years (39–75), 22(73.3%) were males and 8 were(26.6%) females. Dysphagia was the predominant symptom in 28 (93.3%) patients. Results: All 30 patients were evaluable for response and toxicity. Radiological and endoscopic CR was seen in 6(20%), PR in 16(53.3%),5(16.6%) had SD and 3(10%) had PD. Twenty five (83.3%) patients underwent radiotherapy to a total dose of 4500 cGY,5(16.6%) underwent surgery, 2(6.6%) showed complete pathological response. Observed toxicity was predominantly hematologic and leucopenia grade III/IV in 10% of cycles, Hb grade III/IV in 6.6% and thrombocytopenia grade III/IV in 3% of cycles.6.6% patients developed grade III/IV oral mucositis. Conclusions: Addition of paclitaxel to cisplatin and 5FU as neoadjuvant chemotherapy in esophageal cancer appears to be highly effective with complete as well as partial response rates. It can be given safely with manageable side effects. It is predicted that combination of paclitaxel, cisplatin and 5FU having excellent response as neoadjuvant therapy will also produce long term benefits. No significant financial relationships to disclose.
ASO Author Reflections: Lymph Node Ratio After Neoadjuvant Chemotherapy in Locally Advanced Esophageal Cancer
