Definitive concomitant chemoradiotherapy with docetaxel and cisplatin in squamous esophageal carcinoma

Chemoradiotherapy is a standard treatment for esophageal carcinoma. This study evaluated the docetaxel-based definitive concomitant chemoradiotherapy in patients with esophageal squamous cell carcinoma to determine its clinical response and overall survival. In this unicenter trail, we enrolled 59 patients with histologically proven squamous cell carcinoma in the esophagus between March 2004 and December 2007. All patients were staged II to IV and treated with definitive concomitant chemoradiotherapy. Radiotherapy was delivered with conventional fraction, 50-64 Gy in 25-35 fractions. Patients received two cycles of a 1-day regimen containing docetaxel (60 mg/m(2)) and cisplatin (80 mg/m(2)) every 3 weeks during the period of radiotherapy. The chemoradiotherapy was applied as planned in all patients and the median chemotherapy delay time was 6 days (ranging from 2 to 8 days). The overall response rate for 59 evaluable patients was 98.3%, with 42 complete responses and 26 partial responses. During the follow-up time (median 18 months, 4 approximately 53 months), the median overall survival time was 22.6 months. The rate of locoregional progression-free survival, progression-free survival, and overall survival in 3 years was 59.6%, 29.2%, and 36.7%, respectively. Hematologic toxicity Grade 3 and Grade 4 were observed in 39.0% and 20.3% of patients respectively, with severe non-hematologic acute toxicity being infrequent. Eleven patients had pleural effusion after chemoradiotherapy and four of them required therapeutic thoracentesis. Definitive concomitant chemoradiotherapy with docetaxel and cisplatin in squamous cell esophageal carcinoma was associated with a satisfactory outcome and manageable toxicity.