Combined treatment of oxaliplatin and capecitabine in patients with metastatic esophageal squamous cell cancer

Abstract

AIM:To investigate the efficacy and side effects of the combined therapy of oxaliplatin and capecitabine in patients with metastatic esophageal squamous cell cancer (ESCC) and the survival of the patients. METHODS:Sixty-four patients (median age of 63 years) with histological or cytological confirmation of ESCC received oxaliplatin 120 mg/m 2 intravenously on day 1 and capecitabine 1000 mg/m 2 orally twice daily on days 1 to 14 in a 21-d treatment cycle as palliative chemotherapy. Each patient received at least two cycles of treatment. The efficacy, side effects and patient survival were evaluated. RESULTS:The partial response (PR) rate was 43.8% (28/64). Stable disease (SD) rate was 47.9% (26/64), and disease progression rate was 15.6% (10/64). The clinical benefit rate (PR + SD) was 84.4%. The main toxicities were leukopenia (50.0%), nausea and vomiting (51.6%), diarrhea (50.0%), stomatitis (39.1%), polyneuropathy (37.5%) and hand-foot syndrome (37.5%). No grade 4 event in the entire cohort was found. The median progression-free survival was 4 mo, median overall survival was 10 mo (95% CI: 8.3-11.7 mo), and the 1-and 2-year survival rates were 38.1% and 8.2%, respectively. High Karnofsky index, single metastatic lesion and response to the regimen indicated respectively good prognosis. CONCLUSION:Oxaliplatin plus capecitabine regimen is effective and tolerable in metastatic ESCC patients. The regimen has improved the survival moderately and merits further studies.

Has the Practice of Radiation Oncology for Locally Advanced and Metastatic Non-Small-Cell Lung Cancer Changed in Canada?

“…The success of chemotherapy in esophageal and prostate cancer may relate to crp status 27,29,42,43 . Wilop et al correlated changes in crp over time with response to treatment in lung cancer patients receiving chemotherapy 44 .…”

Phase II Study of S-1 plus Cisplatin as First-Line Therapy in Patients with Metastatic Esophageal Carcinoma

“…Recently, new chemotherapy agents such as taxanes, vinorelbine, irinotecan, capecitabine, oxaliplatin, and nedaplatin have been investigated as single agents or in combination in esophageal cancer [22,23,24,25,26,27,28]. As ESCC has the highest incidence in Eastern Asia and parts of Africa, most evidence comes from China, Japan, and Korea.…”

“…The same dose was used in our regimen. Besides, several safety advantages such as pertaining to hand-foot syndrome or oral mucositis (which are not uncommon with 5-FU/capecitabine-based therapies) were achieved by using the S-1/cisplatin regimen [17,24,25]. …”

“…The capecitabine/cisplatin (XP) regimen proves to be a reasonable option with an ORR of 57.8% and a median duration of response in responders of 4.6 months (1-15.6 months) [24]. The capecitabine/oxaliplatin (XELOX) regimen is also an active option with an ORR of 43.8% and an OS of 10 months [25]. Paclitaxel-based regimens are another widely used type of treatment (ORR 41.7-48.6%, PFS 6.1-7 months, and OS 11.5-13 months) [27,28].…”

Letter to the Editor

“…Median overall survival was 10 months; 1 and 2 year survival rates were 38.1% and 8.2% respectively. Although it was not a randomized trial the results are promising when compared to older ones (7).…”