Objective: Esophageal cancer (EC) is a form of gastrointestinal cancer with the worst malignant potential and poor prognosis. This study sought to compare the survival and adverse effect profile in patients with EC treated with Carboplatin and Paclitaxel or 5-Fluorouracil (5-FU) and Cisplatin regimen. 

Patients and Methods: The study was conducted at the Regional Cancer Centre (RCC), Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura, Srinagar, J&K, India for a period of 7 months. A total of 251 patients were included in this retrospective study, of which 177 (Group I) had been treated with the combination of Carboplatin and Paclitaxel while 74 patients (Group II) had been treated with 5-FU and Cisplatin combination.

Results: The median overall survival (OS) was 20.7 months for patients in Group I and 17.1 months for patients in Group II (HR: 1.200; 95% Confidence Interval [CI], p=0.176). The median progression-free survival (PFS) was 12.26 months for subjects of Group I and 12.33 months for Group II subjects (HR: 0.609; 95% CI; p=0.909). Haematological toxicity (≥ grade III) in terms of anaemia, leukocytopenia and thrombocytopenia in Carboplatin and Paclitaxel group (1.7%, 8%, and 18%) was significantly higher than in the 5-FU and Cisplatin group (1.36%, 0%, and 38%) (95% CI; p<0.05). Among non-haematological toxicities, bradycardia was the most notable side-effect of 5-FU and Cisplatin group (18.9%) followed by diarrhoea/vomiting (6.75%) and cough (2.7%). The major side-effect seen in patients treated with the combination of Carboplatin and Paclitaxel was diarrhoea/vomiting (4.52%), followed by mucositis (3.39%) and cough (2.25%) (95% CI; p<0.05).

Conclusions: Results suggest that Carboplatin and Paclitaxel regimen is the preferred regimen for patients with potentially curable EC and has higher patient compliance compared to 5-FU and Cisplatin regimen. Toxicity, excluding haematological events, occurred less frequently in the group that received Carboplatin and Paclitaxel compared to toxicity rates in patients who received 5-FU and Cisplatin regimen.