A retrospective study of docetaxel or paclitaxel in patients with advanced or recurrent esophageal squamous cell carcinoma who previously received fluoropyrimidine- and platinum-based chemotherapy
- 623 Downloads
Fluoropyrimidine plus platinum (FP)-based chemotherapy has been widely used as a first-line regimen for advanced or recurrent esophageal cancer, and taxanes have shown efficacy after FP-based chemotherapy, but there is no standard regimen for second-line chemotherapy (SLC). We retrospectively investigated the clinical features of taxane therapy in SLC for esophageal squamous cell carcinoma (ESCC).
The selection criteria were pathologically proven ESCC; advanced or recurrent disease previously treated with FP at our hospital; performance status (PS) 0–2; and adequate organ function. Docetaxel (DTX) was administered 3-weekly at 70 mg/m2. Paclitaxel (PTX) was administered at 100 mg/m2 weekly for 6 weeks, with 1 week’s rest.
The analysis covered 163 patients from August 2006 to June 2012. Median age was 64 years (range 37–83: DTX group 132 patients and PTX group 31). Progression-free survival and median overall survival (OS) were 2.3 and 6.1 months, respectively, with PTX and 2.3 and 5.3 months with DTX. Response rates were 20.7 % for PTX and 5.9 % for DTX. The rate of grades 3–4 neutropenia was higher with DTX (32.6 %) than with PTX (16.1 %). Grade 3 febrile neutropenia was seen in 6.1 % of DTX recipients but in no PTX group. According to multivariate analyses of OS, PS 2, number of metastatic sites ≧2, and CRP ≧1 mg/dL were independent predictors of poor prognosis.
PTX and DTX were both effective in SLC for ESCC, but their toxicity profiles differed. In terms of febrile neutropenia, PTX seems more appropriate.
KeywordsDocetaxel Esophageal squamous cell carcinoma Paclitaxel Prognostic factor Second-line chemotherapy
Conflict of interest
None of the authors has a conflict of interests.
- 3.Demographic statistics. Ministry of Health, Labour and Welfare, Japan, 2006Google Scholar
- 7.Vanhoefer U, Rougier P, Wilke H et al (2000) Final results of a randomized phase III trial of sequential high-dose methotrexate, fluorouracil, and doxorubicin versus etoposide, leucovorin, and fluorouracil versus infusional fluorouracil and cisplatin in advanced gastric cancer: a trial of the European Organization for Research and Treatment of Cancer Gastrointestinal Tract Cooperative Group. J Clin Oncol 18:2648–2657PubMedGoogle Scholar
- 16.Cox DR (1972) Regression models and life-tables. J R Stat Soc B 34:187–202Google Scholar
- 20.Lorenzen S, Schuster T, Porschen R et al (2009) Cetuximab plus cisplatin-5-fluorouracil versus cisplatin-5-fluorouracil alone in first-line metastatic squamous cell carcinoma of the esophagus: a randomized phase II study of the Arbeitsgemeinschaft Internistische Onkologie. Ann Oncol 20(10):1667–1673PubMedCrossRefGoogle Scholar