What chemotherapy regimen do you recommend with radiation therapy for cervical esophageal squamous cell carcinoma?

Topics: Radiation Oncology • Gastrointestinal Cancers • Esophageal Cancer • Medical Oncology

The upfront plan is to use a definitive radiation dose of 66 Gy. My reading supports the use of 5FU + cisplatin but another doctor is recommending FOLFOX. The PRODIGE5/ACCORD17 trial, which examined the use FOLFOX, comprised mostly (all?) thoracic esophagus cancer, and RT doses were 50 Gy.

Answer from: Medical Oncologist at Academic Institution

I would use weekly carboplatin/paclitaxel in this setting. Fluoropyrimidine + platinum is reasonable but will likely be more toxic, and I'm not aware of any data indicating that it's a more effective regimen.

Comments

Radiation Oncologist at Cleveland Clinic
I read with interest your comments as they are in ...

Answer from: Medical Oncologist at Academic Institution

I have typically offered concurrent FOLFOX rather than 5FU/Cisplatin for definitive therapy of proximal esophageal cancers- either adenocarcinoma or squamous cell carcinoma. The former regimen is more likely to cause neuropathy but in my experience has been more tolerable than 5FU/Cisplatin. While n...

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