Short-term Efficacy of Paclitaxel Plus Concurrent Late-course Accelerated Hyperfractionated Radiotherapy on Elderly Patients with Esophageal Carcinoma

ObjectiveTo evaluate the short-term efficacy and clinical toxicity of late-course accelerated hyperfractionated radiotherapy plus concurrent chemotherapy with China-made paclitaxel in treatment of elderly patients with esophageal carcinoma．MethodsFrom Nov. 2006 to Nov. 2008,88 elder patients with esophageal carcinoma were randomly divided into two groups: 44 cases in the LCAF group receiving LCAF alone ;another 44 cases in the LCAF+C group with additional paclitaxel 30 mg/m2, once per week before radiotherapy for six weeks with premedication of one hour travenous infusion simultaneously. All patients were beforehand laid immobilized with thermoplastic cast. Six MV X-ray or fifteen MV X-ray was employed.The schedule of LCAF was as following: conventional radiotherapy of 2.0 Gy per day，once per day，five days per week，was treated during the first phase to a total dose of 36 Gy，then followed by LCAF(twice per day，1.4~1.5 Gy per fraction，between two fractions more than six hours，to the total dose of 61.2~66 Gy with 36-38 fractions). The toxicity, response rate, one-year local control rate and one-year overall survival rate were evaluated and compared between the two groups. ResultsThe total response rate(CR+PR) in the LCAF+C group and in the LCAF group was 93.2％ and 77.3％,respectively．There was a significant difference(χ2=4.423，0.010.05)， The rate grade 3-4 myelosuppression in LCAF+C was significantly higher than in LCAF(P<0.01). All the toxicities were well tolerated．ConclusionThe toxicity of hyperfractionated radiotherapy delivered concurrently with China-made paclitaxel regimen for elder patients with esophageal cancer is tolerable and the improved short-term effect is promising．But the long-term effect is worth further study．