Advertisement
Journal of Clinical Oncology  
Search for:
Limit by:
  Browse by Subject or Issue
Home Search or Browse JCO My JCO Subscriptions Customer Service Site Map

Journal of Clinical Oncology, Vol 22, No 1 (January 1), 2004: pp. 45-52
© 2004 American Society of Clinical Oncology.
DOI: 10.1200/JCO.2004.05.039

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Save to my personal folders
Right arrow Download to citation manager
Right arrowRights & Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Brenner, B.
Right arrow Articles by Kelsen, D. P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Brenner, B.
Right arrow Articles by Kelsen, D. P.
Social Bookmarking
 Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Phase I Trial of Combined-Modality Therapy for Localized Esophageal Cancer: Escalating Doses of Continuous-Infusion Paclitaxel With Cisplatin and Concurrent Radiation Therapy

Baruch Brenner, David H. Ilson, Bruce D. Minsky, Manjit S. Bains, William Tong, Mithat Gonen, David P. Kelsen

From the Gastrointestinal Oncology Service, Department of Medicine, the Department of Radiation Oncology, the Thoracic Service, Department of Surgery, and the Department of Epidemiology & Biostatistics, Memorial Sloan-Kettering Cancer Center, and the Weill School of Medicine, Cornell University, New York, NY

Address reprint requests to David P. Kelsen, MD, the Gastrointestinal Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021; e-mail: kelsend{at}mskcc.org

PURPOSE: To define the maximum-tolerated dose (MTD) of paclitaxel when given as a weekly 96-hour infusion with cisplatin and radiotherapy for patients with esophageal cancer.

PATIENTS AND METHODS: Thirty-four patients with locally advanced esophageal cancer and three patients with local recurrence or positive resection margins were treated. Weekly paclitaxel doses of 10, 20, 30, 40, 60, and 80 mg/m2, given as a continuous 96-hour infusion, were administered with weekly cisplatin, 30 mg/m2 on day 1, weeks 1 to 6, and concurrent radiation (50.4 Gy). Plasma paclitaxel steady-state levels were measured.

RESULTS: Dose-limiting toxicity, defined as a treatment break longer than 2 weeks for toxicity, occurred in one patient in the 80-mg/m2/wk dose level. Major causes for any (including <= 2 weeks) treatment breaks were mediport complications and neutropenic fever, which occurred mostly at that dose level. At a paclitaxel dose of 60 mg/m2/wk, myelosuppression, mostly neutropenia, was relatively mild and transient; stomatitis, esophagitis, diarrhea. and peripheral neuropathy were uncommon and usually of grade 2 or less. Therefore, the MTD was established at 60 mg/m2/wk. The mean steady-state concentration of paclitaxel at the MTD was 17.2 nmol/L. Complete (R0) resection was possible in 16 (73%) of 22 patients who underwent subsequent surgery, and the pathologic complete response rate was 24%.

CONCLUSION: Weekly, 96-hour infusion of paclitaxel 60 mg/m2/wk, given with concurrent cisplatin and radiotherapy, is a safe and tolerable regimen for patients with localized esophageal cancer. Preliminary efficacy data are encouraging. This regimen is the basis of ongoing Radiation Therapy Oncology Group phase II randomized trials in esophageal and gastric cancers.

Supported in part by grant no. U01 CA69913 from the National Cancer Institute, Bethesda, MD.

Authors' disclosures of potential conflicts of interest are found at the end of this article.


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
JCOHome page
G. K. Schwartz, K. Winter, B. D. Minsky, C. Crane, P. J. Thomson, P. Anne, H. Gross, C. Willett, and D. Kelsen
Randomized Phase II Trial Evaluating Two Paclitaxel and Cisplatin-Containing Chemoradiation Regimens As Adjuvant Therapy in Resected Gastric Cancer (RTOG-0114)
J. Clin. Oncol., April 20, 2009; 27(12): 1956 - 1962.
[Abstract] [Full Text] [PDF]


Home page
JCOHome page
J. A. Ajani, K. Winter, R. Komaki, D. P. Kelsen, B. D. Minsky, Z. Liao, J. Bradley, M. Fromm, D. Hornback, and C. G. Willett
Phase II Randomized Trial of Two Nonoperative Regimens of Induction Chemotherapy Followed by Chemoradiation in Patients With Localized Carcinoma of the Esophagus: RTOG 0113
J. Clin. Oncol., October 1, 2008; 26(28): 4551 - 4556.
[Abstract] [Full Text] [PDF]


Home page
Am Soc Clin Oncol Ed BookHome page
D. H. Ilson
Combined Modality Therapy for Gastric, Esophageal, and Gastroesophageal Junction Cancers
ASCO Educational Book, January 1, 2008; 2008(1): 177 - 182.
[Abstract] [Full Text] [PDF]


Home page
Ann OncolHome page
D. Ilson, R. Wadleigh, L. Leichman, and D. Kelsen
Paclitaxel given by a weekly 1-h infusion in advanced esophageal cancer
Ann. Onc., May 1, 2007; 18(5): 898 - 902.
[Abstract] [Full Text] [PDF]


Home page
The OncologistHome page
W. P. Tew, D. P. Kelsen, and D. H. Ilson
Targeted Therapies for Esophageal Cancer
Oncologist, September 1, 2005; 10(8): 590 - 601.
[Abstract] [Full Text] [PDF]


Home page
Ann OncolHome page
F. Pasini, G. de Manzoni, C. Pedrazzani, A. Grandinetti, E. Durante, M. Gabbani, A. Tomezzoli, C. Griso, A. Guglielmi, G. Pelosi, et al.
High pathological response rate in locally advanced esophageal cancer after neoadjuvant combined modality therapy: dose finding of a weekly chemotherapy schedule with protracted venous infusion of 5-fluorouracil and dose escalation of cisplatin, docetaxel and concurrent radiotherapy
Ann. Onc., July 1, 2005; 16(7): 1133 - 1139.
[Abstract] [Full Text] [PDF]



About
JCO
 Editorial
Roster
 Advertising
Information
 Librarians &
Institutions
 Rights &
Permissions
 PDA Services

Copyright © 2004 by the American Society of Clinical Oncology, Online ISSN: 1527-7755. Print ISSN: 0732-183X
Terms and Conditions of Use
  HighWire Press HighWire Press™ assists in the publication of JCO Online