Clinical Research Papers:
A phase II study of concurrent chemoradiotherapy and erlotinib for inoperable esophageal squamous cell carcinoma
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Chuanhua Zhao1, Li Lin1, Jianzhi Liu1, Rongrui Liu1, Yuling Chen1, Feijiao Ge1, Ru Jia1, Yang Jin1, Yan Wang1, Jianming Xu1
1Department of GI Oncology, 307 Hospital of PLA, Academy of Military Medical Sciences, Beijing, China
Jianming Xu, email: email@example.com
Keywords: esophageal cancer, epidermal growth factor receptor, chemoradiotherapy, erlotinib, paclitaxel
Received: March 27, 2016 Accepted: May 23, 2016 Published: June 03, 2016
Cisplatin-based concurrent chemoradiotherapy for patients with unresectable, locally advanced esophageal squamous cell carcinoma (ESCC) is associated with significant toxicities that are often intolerable. Prognosis for this subgroup of patients remains poor, and new therapeutic approaches are urgently needed. We investigated the efficacy and safety of paclitaxel combined with erlotinib and concurrent radiotherapy in patients with inoperable ESCC. Erlotinib (150 mg) was administered daily for 60 days beginning at the start of radiotherapy, and paclitaxel (45 mg/m²) was administered weekly along with intensity modulated conformal radiotherapy (60 Gy in 30 fractions). The median follow-up time was 21 months. The associations between EGFR and VEGF expression and treatment outcome were evaluated. Among the 21 patients treated, the overall response rate (CR + PR) was 85.6%. The median LPFS, PFS and OS were: 17.5, 14.3, and 22.9 months, respectively. Treatment-related grade 3 toxicities included esophagitis (two patients) and hypoleukemia (one patient). Grade 4 pulmonary toxicity was observed in one patient. Patients expressing EGFR had longer PFS, while those expressing VEGF or with a history of smoking had worse outcomes. Weekly paclitaxel combined with erlotinib and concurrent radiotherapy shows promise as an effective, tolerated regimen for patients with inoperable ESCC.
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