Outcome of weekly carboplatin-paclitaxel-based definitive chemoradiation in oesophageal cancer in patients not considered to be suitable for platinum-fluoropyrimidine-based treatment: a multicentre, retrospective review
dc.contributor.author | Owens, R | |
dc.contributor.author | Cox, C | |
dc.contributor.author | Gomberg, S | |
dc.contributor.author | Pan, Shermaine | |
dc.contributor.author | Radhakrishna, Ganesh | |
dc.contributor.author | Parikh, S | |
dc.contributor.author | Goody, R | |
dc.contributor.author | Hingorani, M | |
dc.contributor.author | Prince, S | |
dc.contributor.author | Bird, T | |
dc.contributor.author | Dorey, N | |
dc.contributor.author | Macgregor, U | |
dc.contributor.author | Al-Chamali, H | |
dc.contributor.author | Hurt, C | |
dc.contributor.author | Mukherjee, S | |
dc.date.accessioned | 2019-12-09T17:23:39Z | |
dc.date.available | 2019-12-09T17:23:39Z | |
dc.date.issued | 2019 | en |
dc.identifier.citation | Owens R, Cox C, Gomberg S, Pan S, Radhakrishna G, Parikh S, et al. Outcome of Weekly Carboplatin-Paclitaxel-based Definitive Chemoradiation in Oesophageal Cancer in Patients Not Considered to be Suitable for Platinum-Fluoropyrimidine-based Treatment: A Multicentre, Retrospective Review. Clin Oncol (R Coll Radiol). 2019. | en |
dc.identifier.pmid | 31662220 | en |
dc.identifier.doi | 10.1016/j.clon.2019.09.058 | en |
dc.identifier.uri | http://hdl.handle.net/10541/622627 | |
dc.description.abstract | AIMS: Although cisplatin-fluoropyrimidine-based definitive chemoradiotherapy (dCRT) is a standard of care for oesophageal cancer, toxicity is significant and limits its use in elderly and frail patients. Weekly carboplatin-paclitaxel-based dCRT provides a viable alternative, although prospective data are lacking in the dCRT setting. Here we report the results of a national, multicentre retrospective review of outcome in patients treated with weekly carboplatin-paclitaxel-based dCRT. MATERIALS AND METHODS: In this multicentre retrospective study of nine radiotherapy centres across the UK we evaluated the outcome of patients who had non-metastatic, histologically confirmed carcinoma of the oesophagus (adenocarcinoma, squamous cell or undifferentiated; World Health Organization performance status 0-2; stage I-III disease) and had been selected to receive weekly carboplatin-paclitaxel-based dCRT as they were considered not suitable for cisplatin-fluoropyrimidine-based dCRT. dCRT consisted of carboplatin AUC 2 and paclitaxel 50 mg/m2 (days 1, 8, 15, 22, 29) and the recommended radiation dose was 50 Gy in 25 daily fractions. We assessed overall survival, progression-free survival (PFS; overall, local and distant), proportion of patients who were failure free at the response assessment (12 weeks after dCRT), treatment compliance and toxicity. RESULTS: In total, 214 patients from nine UK centres were treated between 15 February 2013 and 19 March 2019: 39.7% of patients were ?75 years; 18.7% ? 80 years. Indications for weekly carboplatin-paclitaxel-based dCRT were comorbidities (47.2%), clinician choice (36.4%) and poor tolerance/progression on cisplatin-fluoropyrimidine induction chemotherapy (15.8%). The median overall survival was 24.28 months (95% confidence interval 20.07-30.09) and the median PFS was 16.33 months (95% confidence interval 14.29-20.96). Following treatment, 69.1% (96/139) had a combined complete response on endoscopy with non-progression (complete response/partial response/stable disease) on imaging. The 1- and 2-year overall survival rates for this patient group were 81.9% (95% confidence interval 75.6-86.8%) and 50.6% (95% confidence interval 40.5-60.0%), respectively. Thirty-three per cent (n = 70) of patients experienced at least one grade 3 + acute toxicity (grade 3/4 haematological: 10%; grade 3/4 non-haematological: 32%) and there were no treatment-related deaths. 86.9% of patients completed at least four cycles of concomitant weekly carboplatin-paclitaxel-based chemotherapy and planned radiotherapy was completed in 97.7% (209/214). CONCLUSION: Weekly carboplatin-paclitaxel-based CRT seems to be well tolerated in elderly patients and in those with comorbidities, where cisplatin-fluoropyrimidine-based dCRT is contraindicated. Survival outcomes are comparable with cisplatin-fluoropyrimidine-based dCRT. | en |
dc.language.iso | en | en |
dc.relation.url | https://dx.doi.org/10.1016/j.clon.2019.09.058 | en |
dc.title | Outcome of weekly carboplatin-paclitaxel-based definitive chemoradiation in oesophageal cancer in patients not considered to be suitable for platinum-fluoropyrimidine-based treatment: a multicentre, retrospective review | en |
dc.type | Article | en |
dc.contributor.department | Oxford University Hospital NHS Foundation Trust, Oxford, UK | en |
dc.identifier.journal | Clinical Oncology (R Coll Radiol ) | en |