Results of a planned interim toxicity analysis with trimodality therapy, including carboplatin AUC = 4, paclitaxel, 5-fluorouracil, amifostine, and radiation for locally advanced esophageal cancer: Preliminary analyses and treatment recommendations from the North Central Cancer Treatment Group

Aminah Jatoi, James Martenson, Michelle R. Mahoney, Bradley S. Lair, Jeffrey S. Brindle, Frank Nichols, Normand Caron, Kendrith Rowland, Loren Tschetter, Steven Alberts

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Purpose: An aggressive trimodality approach from the Minnie Pearl Cancer Research Network [carboplatin AUC = 6, days 1 and 22; 5-fluorouracil 225 mg/m2 continuous infusion, days 1-42, paclitaxel 200 mg/m2, days 1 and 22; 45 Gy] has resulted in remarkable pathologic response rates but notable toxicity. This trial was designed to mitigate this toxicity by starting with a lower carboplatin dose, AUC = 4, and by adding subcutaneous amifostine. Methods: This phase II trial included patients with locally advanced, potentially resectable esophageal cancer. All were to receive the above regimen with modifications of carboplatin AUC = 4 and amifostine 500 mg subcutaneously before radiation. All were then to undergo an esophagectomy. A planned interim toxicity analysis after the first 10 patients was to determine whether the carboplatin dose should escalate to AUC = 6. Results: Ten patients were enrolled, and all required dose reductions/omissions during neoadjuvant therapy. One patient died from paclitaxel anaphylaxis. Six patients manifested a complete pathologic response. Conclusion: With this regimen, carboplatin AUC = 4 for patients with locally advanced esophageal cancer is appropriate.

Original languageEnglish (US)
JournalInternational Seminars in Surgical Oncology
Volume1
DOIs
StatePublished - Nov 8 2004

ASJC Scopus subject areas

  • Surgery
  • Oncology

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