CHEMOTHERAPY WITH CISPLATIN AND PACLITAXEL IN PATIENTS WITH LOCALLY ADVANCED, RECURRENT OR METASTATIC ESOPHAGEAL CANCER

Single-agent therapy with paclitaxel is effective against both squamou s cell carcinoma and adenocarcinoma of the oesophagus. However, only l imited data are available on the combination of paclitaxel with other cytotoxic drugs in this entity. Patients with unresectable stage ill, recurrent or metastatic tumours were treated in a multicentre setting with paclitaxel 90 mg m(-2) given over 3 h intravenously, followed by cisplatin 50 mg m(-1). The courses were repeated every 14 days. Twenty patients with squamous cell carcinoma or adenocarcinoma of the oesoph agus were evaluable for response. The overall remission rate was 40% ( 8/20), including 15% (3/20) clinically complete responses. Clinical be nefit response, defined as relief of dysphagia and/or significant gain in weight, was achieved in 70% of the patients. Neutropenia of CTC gr ade 3 occurred only in 10% of the patients; no grade 4 neutropenia and no severe thrombocytopenia was encountered. CTC grade 4 neurotoxicity was seen in 5% of patients. Cisplatin/paclitaxel administered every 1 4 days, was effective in patients with poor prognosis oesophageal canc er and toxicity was acceptable.