Phase II study of concurrent chemoradiation in combination with erlotinib for locally advanced esophageal carcinoma

Int J Radiat Oncol Biol Phys. 2010 Dec 1;78(5):1407-12. doi: 10.1016/j.ijrobp.2009.10.012. Epub 2010 Mar 28.

Abstract

Purpose: To investigate the feasibility and efficacy of concurrent chemoradiation in combination with erlotinib for locally advanced esophageal carcinoma.

Methods and materials: Twenty-four patients with locally advanced esophageal carcinoma were treated with concurrent chemoradiotherapy. A daily fraction of 2.0 Gy was prescribed to a total dose of 60 Gy over 6 weeks. Concurrent paclitaxel (135 mg/m(2), d(1)) and cisplatin (20 mg/m(2), d(1-3)) were administered on Day 1 and Day 29 of the radiotherapy. Erlotinib, an oral epidermal growth factor receptor-tyrosine kinase inhibitor, was taken by every patient at the dose of 150 mg daily during the chemoradiotherapy.

Results: The median follow-up of the 24 patients was 18.6 months (range, 7.1-29.6 months). The 2-year overall survival, local-regional control, and relapse-free survival were 70.1% (95% CI, 50.4-90%), 87.5% (95% CI, 73.5-100%), and 57.4% (95% CI, 36.3-78.7%), respectively. During the chemoradiotherapy, the incidences of acute toxicities of Grade 3 or greater, such as leucopenia and thrombocytopenia, were 16.7 % (4/24) and 8.3% (2/24).

Conclusions: Application of concurrent chemoradiotherapy in combination with erlotinib for locally advanced esophageal carcinoma yielded satisfactory 2-year overall survival and local-regional control. The toxicities were well tolerated.

Publication types

  • Clinical Trial, Phase II

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy*
  • Cisplatin / administration & dosage
  • Combined Modality Therapy / methods
  • Disease-Free Survival
  • Drug Administration Schedule
  • ErbB Receptors / antagonists & inhibitors*
  • Erlotinib Hydrochloride
  • Esophageal Neoplasms / drug therapy*
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / radiotherapy*
  • Feasibility Studies
  • Follow-Up Studies
  • Humans
  • Leukopenia / etiology
  • Middle Aged
  • Neoplasm Staging
  • Paclitaxel / administration & dosage
  • Protein Kinase Inhibitors / therapeutic use
  • Quinazolines / therapeutic use*
  • Radiation Injuries / etiology
  • Radiotherapy Dosage
  • Thrombocytopenia / etiology

Substances

  • Protein Kinase Inhibitors
  • Quinazolines
  • Erlotinib Hydrochloride
  • ErbB Receptors
  • Paclitaxel
  • Cisplatin