Neoadjuvant chemotherapy with liposomal paclitaxel plus platinum for locally advanced esophageal squamous cell cancer: Results from a retrospective study

Background This study analyzed the efficacy and safety of neoadjuvant chemotherapy with liposomal paclitaxel plus platinum in patients with locally advanced resectable esophageal squamous cell carcinoma (ESCC). Methods The data of patients with locally advanced resectable ESCC (staging cT2N + M0, cT3-4aNanyM0, IA-IVA) who received preoperative chemotherapy with liposomal paclitaxel plus platinum (cisplatin, nedaplatin or carboplatin) in HuanXing Cancer Hospital from July 2018 to October 2019 were collected. The primary endpoint of this study was R0 resection rate, and secondary endpoints were pathological complete response (pCR) rate, 1- and 2-year overall survival (OS) rate, 1-year and 18-month disease-free survival (DFS) rate, and safety. Results A total of 32 eligible patients were included in this study. All patients received neoadjuvant chemotherapy and surgery. The R0 resection rate was 93.8%, the pCR rate was 12.5%, and down-staging was achieved in 14 patients (47.8%). Median follow-up was 31.0 months (95% confidence interval [CI] 30.1-31.9 months). The 1- and 2-year OS rates were 96.9% and 78.1%, and the 1-year and 18-month DFS rates were 86.7% and 76.7%, respectively. The median DFS and OS were not reached. The incidence rate of neoadjuvant chemotherapy related grade 3-4 adverse events was 21.9%, including neutropenia (21.9%) and leukopenia (9.4%). Conclusions The results of this study suggest that liposomal paclitaxel combined with platinum as neoadjuvant chemotherapy can provide satisfactory R0 resection rate and survival rate, and significant tumor down-staging effect for patients with locally advanced resectable ESCC, with safety profile.