- In patients with esophageal squamous cell carcinoma, fluorouracil plus paclitaxel instead of cisplatin offers no survival benefit in patients receiving definitive concurrent chemoradiotherapy (dCRT).
Why this matters
- Regimens with paclitaxel have been used in concurrent chemotherapy “for several decades … despite the lack of level 1 evidence,” the authors say.
- They suggest that fluorouracil and cisplatin remain the standard regimen in these patients.
- Median follow-up: 48.7 (interquartile range, 42.6-60.9) months.
- 3-year OS:
- 55.4% with paclitaxel vs 51.8% with cisplatin;
- HR, 0.905 (P=.448).
- 3-year PFS also did not differ:
- 43.7% with paclitaxel vs 45.5% cisplatin;
- HR, 0.973 (P=.828).
- Paclitaxel group had lower incidence of some adverse events (e.g., anorexia, nausea, vomiting, fatigue) but higher incidence of others (≥grade 3 leukopenia, radiation dermatitis, radiation pneumonitis).
- 436 patients at 6 centers randomly allocated to paclitaxel or cisplatin groups.
- 138 and 152 completed, respectively.
- Primary endpoint: 3-year OS.
- Funding: National Natural Science Foundation of China.
- Different paclitaxel regimens not compared.