Noronha, VPatil, VBhosale, BJoshi, APurandare, NPrabhash, K2013-10-042013-10-042013-04Noronha V, Patil V, Bhosale B, Joshi A, Purandare N, Prabhash K. Metronomic weekly paclitaxel in advanced unresectable esophageal cancer. Indian Journal of Cancer. 2013 Apr-June; 50(2): 128-134.http://imsear.searo.who.int/handle/123456789/148637CONTEXT: Advanced esophageal cancer is aggressive with an expected median survival of 6‑7 months. Combination chemotherapy regimens provide effective palliation, but result in substantial toxicity. MATERIALS AND METHODS: Retrospective analysis of prospectively collected data of patients with advanced esophageal cancer, not amenable to definitive intent therapy who were treated with intravenous weekly paclitaxel. RESULTS: Between October 2010 and August 2011, 51 patients were included. Median age was 56 years, with a male: female ratio of 2.9:1. 29% were mid esophageal and 55% were lower third and gastroesophageal junction tumors. 65% of the tumors had squamous histology. Performance status was > 2 in 45%. 61% patients had received prior therapy, either definitive or palliative. 51% patients were platinum‑pre‑treated and 29% had received prior 3 weekly paclitaxel. 76% patients had distant metastases. Median number of cycles of weekly paclitaxel delivered was 11. 71% of patients had improvement in dysphagia, with a median time to symptom improvement of 9 days. In 72% patients, the feeding nasogastric tube could be removed. Overall response rate was 49% (complete remission: 4%, partial remission: 45%, stable disease: 13%). Median progression free survival was 4.7 months (confidence interval [95% CI: 3.7‑5.7 months]) and median overall survival was 7.5 months (95% CI: 3.1‑11.8 months). Histopathology, performance status and pre‑treatment albumin significantly affected survival. The most common grade 3/4 toxicities included hyponatremia (14%), fatigue (16%), diarrhea (12%), anemia (31%), neutropenia (10%) and febrile neutropenia (4%). CONCLUSIONS: Metronomic weekly paclitaxel chemotherapy may provide palliative benefit in advanced unresectable metastatic esophageal cancer with minimal toxicity.enChemotherapyesophageal neoplasmsesophagogastric junctionesophagusmetronomicpaclitaxelpalliativeAdministration, MetronomicAdultAgedCarcinoma, Squamous Cell --drug therapyCarcinoma, Squamous Cell --pathologyCisplatin --administration & dosageDisease-Free SurvivalDrug-Related Side Effects and Adverse Reactions --pathologyEsophageal Neoplasms --drug therapyEsophageal Neoplasms --pathologyFemaleHumansMaleMiddle AgedNeoplasm StagingPaclitaxel --administration & dosagePaclitaxel --adverse effectsArticle