Definitive concurrent chemoradiotherapy with paclitaxel plus carboplatin is superior to cisplatin plus 5‐fluorouracil in patients with inoperable esophageal squamous cell carcinoma using retrospective, real‐world evidence

Abstract Background The optimal definitive chemotherapy regimen during concurrent chemoradiotherapy (CRT) for patients with advanced esophageal squamous cell carcinoma (ESCC) remains unclear because of conflicting evidence. This study aimed to compare the effectiveness of taxane‐based chemotherapy w...

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Autores principales:	Jason Chia‐Hsun Hsieh, Pin‐Chun Chiang, Tsung‐Min Hung, Yin‐Kai Chao, Yung‐Chia Kuo, Chih‐Tsung Wen, Po‐Jung Su, Meng‐Ting Peng, Huan‐Wu Chen, Hui‐Ling Liu, Hsien‐Kun Chang, Min‐Hsien Wu, Hung‐Ming Wang
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	5‐fluorouracil carboplatin cisplatin definitive chemoradiotherapy esophageal squamous cell carcinoma paclitaxel Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/2e403fc1c54744b5988cbb4089b73642
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spelling	oai:doaj.org-article:2e403fc1c54744b5988cbb4089b736422021-12-01T04:49:14ZDefinitive concurrent chemoradiotherapy with paclitaxel plus carboplatin is superior to cisplatin plus 5‐fluorouracil in patients with inoperable esophageal squamous cell carcinoma using retrospective, real‐world evidence2045-763410.1002/cam4.4025https://doaj.org/article/2e403fc1c54744b5988cbb4089b736422021-12-01T00:00:00Zhttps://doi.org/10.1002/cam4.4025https://doaj.org/toc/2045-7634Abstract Background The optimal definitive chemotherapy regimen during concurrent chemoradiotherapy (CRT) for patients with advanced esophageal squamous cell carcinoma (ESCC) remains unclear because of conflicting evidence. This study aimed to compare the effectiveness of taxane‐based chemotherapy with that of conventional cisplatin plus 5‐fluorouracil (PF) as the chemotherapy regimen in definitive CRT for ESCC. Patients and Methods This retrospective study included patients with ESCC who received paclitaxel plus carboplatin (PC) or PF during definitive CRT between May 2012 and February 2015 in a medical center in Taiwan. Survival outcomes were compared after adjustment for risk factors. Results Overall, 229 patients were evaluated. Patients in the PC group had an objective response rate of 71.1% compared with the 51.4% of the PF group (p = 0.016). The PC group showed a significantly longer progression‐free survival (PFS, p = 0.002) and overall survival (OS, p = 0.019) than the PF group. Salvage surgery also helped prolong both the PFS and OS (p < 0001). Sex (male vs. female, HR, 1.831; 95% CI, 1.016–3.303), clinical stage (HR, 1.282; 95% CI, 1.069–1.537), accumulative radiation dose (≥41.4 Gy vs. <41.4 Gy; HR, 0.640; 95% CI, 0.413–0.993), salvage surgery (yes vs. no, HR: 0.412, 95% CI: 0.298–0.570), and regimen (PF vs. PC; HR, 1.514; 95% CI, 1.109–2.067) were independent prognostic factors for cancer mortality. Conclusion Compared with the PF regimen, the PC regimen for definitive CRT yielded significantly increased response rates and longer survival times; therefore, the PC regimen may be preferable for chemotherapy for definitive CRT in patients with advanced ESCC.Jason Chia‐Hsun HsiehPin‐Chun ChiangTsung‐Min HungYin‐Kai ChaoYung‐Chia KuoChih‐Tsung WenPo‐Jung SuMeng‐Ting PengHuan‐Wu ChenHui‐Ling LiuHsien‐Kun ChangMin‐Hsien WuHung‐Ming WangWileyarticle5‐fluorouracilcarboplatincisplatindefinitive chemoradiotherapyesophageal squamous cell carcinomapaclitaxelNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancer Medicine, Vol 10, Iss 23, Pp 8300-8309 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	5‐fluorouracil carboplatin cisplatin definitive chemoradiotherapy esophageal squamous cell carcinoma paclitaxel Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	5‐fluorouracil carboplatin cisplatin definitive chemoradiotherapy esophageal squamous cell carcinoma paclitaxel Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Jason Chia‐Hsun Hsieh Pin‐Chun Chiang Tsung‐Min Hung Yin‐Kai Chao Yung‐Chia Kuo Chih‐Tsung Wen Po‐Jung Su Meng‐Ting Peng Huan‐Wu Chen Hui‐Ling Liu Hsien‐Kun Chang Min‐Hsien Wu Hung‐Ming Wang Definitive concurrent chemoradiotherapy with paclitaxel plus carboplatin is superior to cisplatin plus 5‐fluorouracil in patients with inoperable esophageal squamous cell carcinoma using retrospective, real‐world evidence
description	Abstract Background The optimal definitive chemotherapy regimen during concurrent chemoradiotherapy (CRT) for patients with advanced esophageal squamous cell carcinoma (ESCC) remains unclear because of conflicting evidence. This study aimed to compare the effectiveness of taxane‐based chemotherapy with that of conventional cisplatin plus 5‐fluorouracil (PF) as the chemotherapy regimen in definitive CRT for ESCC. Patients and Methods This retrospective study included patients with ESCC who received paclitaxel plus carboplatin (PC) or PF during definitive CRT between May 2012 and February 2015 in a medical center in Taiwan. Survival outcomes were compared after adjustment for risk factors. Results Overall, 229 patients were evaluated. Patients in the PC group had an objective response rate of 71.1% compared with the 51.4% of the PF group (p = 0.016). The PC group showed a significantly longer progression‐free survival (PFS, p = 0.002) and overall survival (OS, p = 0.019) than the PF group. Salvage surgery also helped prolong both the PFS and OS (p < 0001). Sex (male vs. female, HR, 1.831; 95% CI, 1.016–3.303), clinical stage (HR, 1.282; 95% CI, 1.069–1.537), accumulative radiation dose (≥41.4 Gy vs. <41.4 Gy; HR, 0.640; 95% CI, 0.413–0.993), salvage surgery (yes vs. no, HR: 0.412, 95% CI: 0.298–0.570), and regimen (PF vs. PC; HR, 1.514; 95% CI, 1.109–2.067) were independent prognostic factors for cancer mortality. Conclusion Compared with the PF regimen, the PC regimen for definitive CRT yielded significantly increased response rates and longer survival times; therefore, the PC regimen may be preferable for chemotherapy for definitive CRT in patients with advanced ESCC.
format	article
author	Jason Chia‐Hsun Hsieh Pin‐Chun Chiang Tsung‐Min Hung Yin‐Kai Chao Yung‐Chia Kuo Chih‐Tsung Wen Po‐Jung Su Meng‐Ting Peng Huan‐Wu Chen Hui‐Ling Liu Hsien‐Kun Chang Min‐Hsien Wu Hung‐Ming Wang
author_facet	Jason Chia‐Hsun Hsieh Pin‐Chun Chiang Tsung‐Min Hung Yin‐Kai Chao Yung‐Chia Kuo Chih‐Tsung Wen Po‐Jung Su Meng‐Ting Peng Huan‐Wu Chen Hui‐Ling Liu Hsien‐Kun Chang Min‐Hsien Wu Hung‐Ming Wang
author_sort	Jason Chia‐Hsun Hsieh
title	Definitive concurrent chemoradiotherapy with paclitaxel plus carboplatin is superior to cisplatin plus 5‐fluorouracil in patients with inoperable esophageal squamous cell carcinoma using retrospective, real‐world evidence
title_short	Definitive concurrent chemoradiotherapy with paclitaxel plus carboplatin is superior to cisplatin plus 5‐fluorouracil in patients with inoperable esophageal squamous cell carcinoma using retrospective, real‐world evidence
title_full	Definitive concurrent chemoradiotherapy with paclitaxel plus carboplatin is superior to cisplatin plus 5‐fluorouracil in patients with inoperable esophageal squamous cell carcinoma using retrospective, real‐world evidence
title_fullStr	Definitive concurrent chemoradiotherapy with paclitaxel plus carboplatin is superior to cisplatin plus 5‐fluorouracil in patients with inoperable esophageal squamous cell carcinoma using retrospective, real‐world evidence
title_full_unstemmed	Definitive concurrent chemoradiotherapy with paclitaxel plus carboplatin is superior to cisplatin plus 5‐fluorouracil in patients with inoperable esophageal squamous cell carcinoma using retrospective, real‐world evidence
title_sort	definitive concurrent chemoradiotherapy with paclitaxel plus carboplatin is superior to cisplatin plus 5‐fluorouracil in patients with inoperable esophageal squamous cell carcinoma using retrospective, real‐world evidence
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/2e403fc1c54744b5988cbb4089b73642
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Definitive concurrent chemoradiotherapy with paclitaxel plus carboplatin is superior to cisplatin plus 5‐fluorouracil in patients with inoperable esophageal squamous cell carcinoma using retrospective, real‐world evidence

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