By Dr Sharan Sharma

According to a new retrospective analysis published in the current issue of American Journal of Clinical Oncology, concurrent chemoradiotherapy with carboplatin/paclitaxel is well-tolerated and provided superior overall and disease-specific survival in locally advanced oesophageal cancer compared with the cisplatin/irinotecan combination. Researchers from the medical University of South Carolina identified 57 patients between January 2000 and December 2007 out of which 38 were in Cisplatin/irinotecan and 19 were in carboplatin/paclitaxel group. Groups were well balanced by clinical, pathologic, staging and treatment related factors. Cisplatin/irinotecan group was treated with 2 cycles of induction chemotherapy followed by concurrent chemoradiotherapy, whereas the carboplatin/paclitaxel group began with chemoradiotherapy followed by 2 additional cycles of chemotherapy. The results revealed no significant difference in toxicities between the groups. At a median survivor follow-up of 37.6 months for the entire population, 22 patients were alive (16 without evidence of disease). The 3-year overall survival estimates were 19.7% for the cisplatin/irinotecan group versus 56.1% for the carboplatin/paclitaxel group (P = 0.022). Estimated 3-year cancer-specific survivals were 24.6% for the cisplatin/irinotecan group versus 59.3% for the carboplatin/paclitaxel group (P = 0.033).

According to the researchers some other studies have demonstrated similar favourable outcomes for carboplatin/paclitaxel chemoradiotherapy compared with cisplatin/irinotecan chemoradiotherapy. The researchers, however, caution against drawing solid conclusion from their study. They add "The retrospective design of this study limits the conclusions which may be drawn from the findings; however, these findings are hypothesis-generating and formal prospective comparison of these regimens may be considered to determine a future comparator against cisplatin/5-fluorouracil."