Skip to main content

Safety and efficacy of paclitaxel plus carboplatin versus paclitaxel plus cisplatin in neoadjuvant chemoradiotherapy for patients with locally advanced esophageal carcinoma: a retrospective study

A Correction to this article was published on 05 May 2023

This article has been updated


Background and purpose

We evaluated and compared the efficacy and safety of chemotherapy with paclitaxel plus cisplatin (TP) or carboplatin (TC) in patients with locally advanced esophageal squamous cell carcinoma (LA-ESCC) who underwent neoadjuvant chemoradiotherapy (NCRT).

Materials and methods

This single-center retrospective study assessed patients with LA-ESCC (cT2N + M0, cT3-4aNanyM0) receiving NCRT plus curative-intent esophagectomy with TP or TC regimen. The primary endpoints were grade ≥ 3 adverse events (AEs) and overall survival (OS). AEs were compared using a t-test according to CTCAE 4.0. The Kaplan–Meier survival curves were compared using the log-rank test; the treatment effect was measured using hazard ratios and 95% confidence intervals.


We included 151 and 50 patients in the TC and TP groups, respectively. Baseline demographic and clinical characteristics were well balanced between groups. The TP group exhibited significantly higher hematologic and non-hematologic AEs than the TC group, and the noticeable difference was the incidence of febrile neutropenia of grade 3 or higher (P = 0.011). No significant intergroup differences were noted considering postoperative complications, resection margins, or pathological complete remission rate (all P > 0.05). OS and progression-free survival (PFS) did not significantly differ between groups. The estimated 3-year OS and PFS rates were 65.1% versus 69.4% and 58.4% versus 53.5% for TP and TC groups, respectively.


In patients with LA-ESCC, we recommend TC, not TP, as an optimal chemotherapy regimen for NCRT, given its superiorsafety profile and comparable efficacy.


Esophageal cancer is the eighth most common malignancy and the sixth leading cause of cancer-related deaths worldwide [1]. In Asian countries, including China and Japan, esophageal squamous cell carcinoma (ESCC) is the predominant histological type [2], and locally advanced disease was the most common stage in newly diagnosed patients with esophageal cancer. Neoadjuvant chemoradiotherapy (NCRT) followed by radical esophagectomy is the standard treatment for locally advanced ESCC (LA-ESCC) owing to its survival benefits [3,4,5].

Several studies have confirmed that the most suitable dose of NCRT for esophageal cancer is 39.6–45.0 Gy [6,7,8], and a fractionated dose of 40 Gy is currently recommended as the standard dose in neoadjuvant radiotherapy [9]. Following the publication of the CROSS trial, the chemotherapy regimen paclitaxel plus carboplatin (TC) was widely applied in NCRT for LA-ESCC [10]. TC regimens have gained considerable popularity owing to their potential for low toxicity. Meanwhile, a meta-analysis has indicated that NCRT with paclitaxel plus cisplatin (TP) was more effective than cisplatin plus 5-fluorouracil (PF) in LA-ESCC [11]. However, cisplatin is known to be associated with severe side effects, including ototoxicity, neurotoxicity, and myelosuppression [12, 13]. It should be noted that the TP regimen may result in poor tolerance to neoadjuvant treatment owing to associated adverse events (AEs). However, the optimal neoadjuvant chemotherapy regimen remains poorly established, given the lack of head-to-head randomized controlled trials (RCTs).

In the present single-center retrospective study, we comprehensively reviewed the safety and efficacy profiles of the TP and TC regimens in patients with LA-ESCC undergoing standard NCRT. The purpose of this study was to compare the safety of TP and TC regimens by comparing treatment-related AEs and the efficacy of TP and TC regimens, considering pathological complete remission (pCR) rate, radical resection rate (R0 resection rate), and 3-year overall survival (OS) and progression-free survival (PFS).



Herein, we retrospectively reviewed patients with LA-ESCC who had received NCRT followed by surgery at Sichuan Cancer Hospital and Institute between May 2017 and June 2021. The inclusion criteria were as follows: 1. Newly diagnosed patients with histologically confirmed resectable LA-ESCC; LA-ESCC, defined as pathologically proven ESCC, with clinical stages of TNM classification cT1-2 N + M0 or cT3–cT4aNanyM0, according to the American Joint Committee on Cancer Staging System (UICC-AJCC) 8th edition [14]; 2. Eastern Cooperative Oncology Group (ECOG) performance score of 01 [15]; 3. Patients who received NCRT followed by resectional surgery; 4. TC and TP chemotherapy regimens used were employed. Exclusion criteria were as follows: 1. Patients who had received prior treatment for primary tumors or nodes; 2. All non-squamous cell carcinomas, including adenocarcinoma or small cell carcinoma;. Patients who received chemotherapy only, radiotherapy only, or neither before surgery; 4. Patients treated with NCRT only and did not undergo surgery; 5. Patients who received sequential chemoradiotherapy, 6. Patients whose chemotherapy regimen induced unknown changes. This retrospective analysis was approved by the appropriate institutional review board.

Chemotherapy regimens

The TP group regimen consisted of paclitaxel 135–175 mg/m2 (day 1) and cisplatin 75 mg/m2 (day 1–3) at weeks 1 and 4 for 2 cycles, or paclitaxel 50 mg/m2 (day 1) and cisplatin 30 mg/m2 (day 1) administered weekly during radiation therapy (RT) for 4 cycles. The TC group regimen comprised a paclitaxel dose of 135–175 mg/m2 (day 1) and carboplatin administered at an area under the curve of 35 mg/mL/min (day 1) at weeks 1 and 4 for 2 cycles. The dose of chemotherapy regimens and dose adjustments were determined by medical oncologists.

Radiotherapy scheme

Gross tumor volume (GTV) was contoured according to clinical imaging investigations such as esophagoscopy, computed tomography (CT), and positron emission tomography-computed tomography (PET-CT). The clinical target volume (CTV) was defined as the GTV plus a 2–3-cm margin in the cranial-caudal direction and a 0.5-cm margin in the transverse plane, without the CTV boundary exceeding anatomical barriers, such as blood vessels. The median total radiotherapy dose was 40 Gy (2.0 Gy per fraction). Intensity-modulated RT (IMRT) was concurrently initiated with the first cycle of chemotherapy and was administered 5 days per week during 4–5 weeks of radiotherapy.

Safety evaluation

AEs and postoperative complications were used to evaluate safety. Acute AEs (occurring within 3 months after NCRT) during chemoradiation were graded according to the Common Terminology Criteria for Adverse Events version 4.0. The severity of RT-induced esophagitis and pneumonitis was graded according to the Radiation Therapy Oncology Group (RTOG) acute radiation morbidity scoring criteria [16]. Postoperative complications were defined as grade ≥ 3 AEs according to the Clavien-Dindo classification [17].

Efficacy evaluation

Effectiveness was assessed using the pCR rate, R0 resection rate, and 3-year OS and PFS. pCR was defined as the absence of gross or microscopic tumor tissue in both the primary lesion and lymph nodes upon examining the surgical specimen. R0 was defined as microscopically negative surgical margins. Incomplete resection was defined as the presence of microscopically positive surgical margins (R1) and gross macroscopic residual tumor tissue (R2). OS was calculated from the date of diagnosis to death. PFS was calculated from the date of treatment initiation to the date of locoregional progression, distant metastasis, or death of any cause.

Statistical analysis

Statistical analysis was performed using R language (R version 4.0.3). Kaplan–Meier survival curves were compared using the log-rank test. For descriptive statistics, continuous variables with normal distribution are presented as the mean ± standard deviation, whereas continuous variables with non-normal distribution are presented as median values (range). Categorical variables are described as counts and percentages. Statistical comparisons were made using paired t-test or unpaired, two-tailed t-test (as appropriate), with p < 0.05 deemed statistically significant. The survival benefit was measured using hazard ratios (HR) and its 95% confidence intervals (CI).


Patient characteristics

After excluding 120 patients, 201 patients were included in the present study, of which 50 and 151 patients received TP and TC regimens, respectively. Table 1 summarizes the baseline characteristics of enrolled patients in both groups. The median age of the patients was 61 (IQR: 54–65) years, with a male to female ratio of 6.75. Most patients were aged < 65 years (71.1%). Considering the total population, most patients were smokers (n = 137, 68.2%) and consumed alcoholic beverages (n = 132, 65.7%). The tumor was mainly located in the lower esophagus (49.8%), and the proportion of patients with stage III disease was 73.1%. The patient characteristics in both groups were well balanced. There were no significant differences in age, sex, ECOG performance, tumor location, and clinical T and N stages. Comorbidities before the treatment such as diabetes, chronic obstructive pulmonary disease (COPD), hypertension, coronary heart disease (CHD) and hepatitis B mellitus were also investigated. The incidence was 4% (8/201) for diabetes, 1% (2/201) for COPD, 18.4% (37/201) for hypertension, 0.5% (1/201) for CHD and 3.5% (7/201) for hepatitis B. The comorbidities between the TC and TP groups were similar (Additional file 1: Table S1).

Table 1 Patient characteristics

Toxicity of concurrent chemoradiotherapy

As shown in Table 2, 45 (86%) and 141 (93.4%) patients in the TP and TC groups, respectively, completed chemotherapy (p = 0.139). No significant differences in chemotherapy incompletion rates were noted between groups, mainly because patients could not tolerate chemoradiotherapy-related AEs. The TP group exhibited significantly higher hematologic (leukopenia, p = 0.006; neutropenia, p = 0.016; thrombocytopenia, p = 0.026) and non-hematologic AEs (nausea, p = 0.038; anorexia, p = 0.047; febrile neutropenia, p = 0.01) of all grades than the TC group (Additional file 1: Table S3). Hematologic and non-hematologic AEs of grade ≥ 3 were observed in 72 (35.8%) and 45 (22.4%) patients, respectively, in the intention-to-treat population (Table 2). Patients treated with TP (46%) presented a higher incidence of hematologic grade ≥ 3 AEs than those in the TC (32.5%) group, although the difference was not statistically significant (p = 0.118). The most notable difference was the incidence of leukopenia (46% vs. 28.5%, p = 0.054). The incidence of grade ≥ 3 non-hematologic AEs was significantly lower in the TC group than in the TP group (17.2 vs. 38%, p = 0.004), with particular differences in febrile neutropenia rates (10 vs. 1.3%, p = 0.011).

Table 2 Treatment compliance and major toxicities

Postoperative complications

Table 3 summarizes grade ≥ 3 postoperative complications according to the Clavien-Dindo classification. The overall incidence of complications was 26.4%, which was similar between the TP and TC group (20 vs. 28.5%, p = 0.32). The most frequent major postoperative complications were pleural effusion (12.4%), anastomotic fistula (7.5%) and pneumonia (5.5%). Overall, no significant between-group differences were observed in the incidence of postoperative complications.

Table 3 Postoperative complications

Surgical outcomes

Among the 151 patients in the TC group, 146 (96%), 4 (2.6%), and 2 (1.4%) achieved R0, R1, and R2 resection, respectively. Forty-nine patients (98%) in the TP group achieved R0 resection, and 1 patient (2%) achieved R1 resection. Overall, 66 of 201 patients achieved pCR (32.8%). The pCR rate did not differ significantly between the TP and TC groups (38 vs. 31.1%, p = 0.469). No statistically significant intergroup differences were noted in terms of perineural invasion, lymphovascular invasion, resection margins, or pCR rates (all p > 0.05) (Table 4).

Table 4 Pathological findings

Of the 201 patients who received NCRT, 23.9% of patients did not show any downstaging, while 76.1% showed a decrease in at least one T stage. 88.1% patients showed a decrease in at least one N stage. The pathological response assessment was scored using the tumor regression grade (TRG) of the Becker criteria. As shown in the following table, 81 (40.3%), 46 (22.9%), 60 (29.9%), and 14 (7%) patients revealed no residual tumor (TRG 1a), < 10% residual tumor per tumor area (TRG 1b), 10%–50%residual tumor per tumor area (TRG 2), and > 50% residual tumor per tumor area (TRG 3) response in Additional file 1: Table S2, respectively. The differences of postoperative T/N stage downstaging and TRG score between the TP and TC groups were not statistically significant.


In total, 50 (24.9%) patients were dead at the end of the follow-up period. With a median follow-up of 26.9 months, the 3-year OS and 3-year PFS were 67.7 and 54.4%, respectively, for the entire population. There were no significant differences between the TP and TC groups considering OS (HR 1.093; 95%CI, 0.59–2.04; p = 0.78) and PFS (HR 1.252; 95%CI, 0.73–2.14; p = 0.41) (Fig. 1A, B). The 1-, 2-, and 3-year OS rates were 93.9, 78.3, and 69.4%, respectively, for patients in the TC groupand 92, 78.4, and 65.1%, respectively, for those in the TP group (Table 2). The 3-year PFS rates were 58.4 (95%CI, 44.7–76.3) and 53.5% (95%CI, 43.8–65.4) in the TP and TC groups, respectively.

Fig. 1
figure 1

OS (A) and PFS (B) curve of TP and TC group

We also investigated the outcome of the patients who received neoadjuvant treatment in the first place, but could not complete the treatment course. As shown in Table 2, total of 8.5% (17/201) patients did not complete chemotherapy. In these 17 patients, 4 (23.5%) of them were dead at the end of the follow-up period. Patients were separated into two groups according to completed chemotherapy or not for survival analysis. The 3-year OS rates were 68.3 (95%CI, 60.2–77.5) and 63.6% (95%CI, 38.2–100) in the complete chemotherapy and not complete groups, respectively. There were no significant differences between the two groups considering OS (HR 0.82; 95%CI, 0.29–2.28; p = 0.7) and PFS (HR 1.022; 95%CI, 0.47–2.23; p = 0.96).


To the best of our knowledge, this is the first study to compare TC and TP regimens in patients with LA-ESCC for NCRT. In the present retrospective study, we aimed to evaluate whether the TC regimen was superior to the TP regimen, which is a better chemotherapy regimen for NCRT in patients with LA-ESCC. Herein, we evaluated AEs and treatment-related effects of TC and TP regimens. The results suggest that either hematologic or non-hematologic AEs occurred less frequently in the TC group during NCRT. We noted no significant differences in postoperative complications. In addition, the incidence of pathological findings (including pCR, R0 resection rate and TRG grade) and survival outcomes were similar in both regimens. The TC regimen exhibits low toxicity and comparable efficacy.

The weekly TC regimen has afforded excellent efficacy in the CROSS study [10]. Since then, the carboplatin plan has been widely accepted and recommended by the National Comprehensive Cancer Network guidelines as the standard chemotherapy regimen for concurrent chemoradiotherapy, including neoadjuvant and definitive therapy. Regarding safety, patients in the TC group experienced mild AEs in the present study, with fewer grade 3 AEs and higher hematologic and gastrointestinal toxic effects than those in the TP group. However, toxic effects in the present study were more severe than those in the CROSS study, especially hematologic toxic effects (33.8% for over grade 3 leukopenia), which could be attributed to higher doses and fewer cycles of chemotherapy regimens. Herein, all patients who received the triweekly TC regimen completed two cycles of chemotherapy on an in-patient basis, which provided better management of the patient’s condition and AEs over a short period. Moreover, fewer chemotherapy cycles can result in larger financial benefits. However, patients who underwent weekly regimens mostly underwent outpatient chemotherapy. Conversely, a triweekly regimen is worthy of clinical consideration and application.

The nutritional status of patients with esophageal cancer tends to be poor, and malnutrition can lead to poor prognosis and death [18, 19]. Gastrointestinal AEs is a major factor in the aggravation of poor undernutrition condition in the treatment of patients with LA-ESCC. Thus, the management of adverse reactions in the alimentary tract is critical during chemoradiotherapy. Neoadjuvant therapy-related AEs can also have serious consequences, including failure to complete chemotherapy cycles, high risk of failure to progress to surgical resection, and poor OS [20,21,22,23]. In our study, the TP regmen shows higher rates of nausea (p = 0.038) and anorexia (p = 0.047), which result in a number of potential risk factors for malnutrition and poor prognosis. Therefore, we recommend the TC regimen as a superior alternative for NCRT.

Although the superiority of the TP regimen has been previously reported [11, 24, 25], a recent RCT has shown that TP does not afford better OS than TC regimens for definitive chemoradiation in patients with LA-ESCC [26]. However, higher rates of hematologic and gastrointestinal toxic effects were observed in the cisplatin group than in the carboplatin group. Similarly, another study has revealed that the TP regimen did not confer a survival advantage over other platinum-based therapies combined with paclitaxel in definitive chemoradiation [27]. Our findings support those reported in previous reports, and there was no significant difference in OS and PFS between the TC and TP regimens.

The limitations of the present study need to be addressed. First, this was a retrospective cohort study, with potential selection bias when compared with prospective randomized controlled studies. We attempted to match the two groups to eliminate the influence of bias and found that baseline characteristics were well balanced, implying that some bias may exist but remains insignificant. In addition, the follow-up durations were relatively short (mean follow-up duration, 26.9 months), and the median OS was not reached. Moreover, in our cohort, episodes of AEs were under-reported, given that this information was not prospectively gathered, and these mild events would not have warranted intervention or a change in treatment. A larger study comparing TC and TP regimens for NCRT in LA-ESCC is warranted.


The findings of the present study indicate that the TC regimen is a safe and effective (equivalent) alternative to the TP regimen for NCRT in patients with LA-ESCC. Therefore, we recommend the TC regimen as a better option for NCRT. A future study comparing the TC and TP regimens for concurrent NCRT in LA-ESCC is warranted.

Availability of data and materials

All data generated and analyzed during this study are included in this published article.

Change history



Paclitaxel plus cisplatin


Paclitaxel plus carboplatin


Locally advanced esophageal squamous cell carcinoma


Neoadjuvant chemoradiotherapy


Adverse events


Overall survival


Progression-free survival


Hazard ratios


Confidence intervals


Esophageal squamous cell carcinoma


Cisplatin plus 5-fluorouracil


Randomized controlled trials


Pathological complete remission


American Joint Committee on Cancer Staging System


Eastern Cooperative Oncology Group


National Cancer Institute Common Terminology Criteria for Adverse Events




Gross tumor volume


Computed tomography


Positron emission tomography-computed tomography


Clinical target volume


Intensity-modulated RT


Radiation Therapy Oncology Group


  1. Uhlenhopp DJ, Then EO, Sunkara T, Gaduputi V. Epidemiology of esophageal cancer: update in global trends, etiology and risk factors. Clin J Gastroenterol. 2020;13:1010–21.

    Article  PubMed  Google Scholar 

  2. Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol. 2006;24:2137–50.

    Article  PubMed  Google Scholar 

  3. Lordick F, Mariette C, Haustermans K, Obermannova R, Arnold D, Comm EG. Oesophageal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2016;27:V50–7.

    Article  CAS  PubMed  Google Scholar 

  4. Kuwano H, Nishimura Y, Oyama T, Kato H, Kitagawa Y, Kusano M, et al. Guidelines for diagnosis and treatment of carcinoma of the esophagus April 2012 edited by the Japan Esophageal Society et al. Esophagus Jpn Esophageal Soc. 2015;12:1–30.

    Article  Google Scholar 

  5. Ajani JA, D’Amico TA, Bentrem DJ, Chao J, Corvera C, Das P, et al. Esophageal and esophagogastric junction cancers, Version 2.2019, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2019;2019(17):855–83.

    Article  CAS  Google Scholar 

  6. Buckstein M, Rhome R, Ru M, Moshier E. Neoadjuvant chemoradiation radiation dose levels for surgically resectable esophageal cancer: predictors of use and outcomes. Dis Esophagus. 2018.

    Article  PubMed  Google Scholar 

  7. Worrell SG, Towe CW, Dorth JA, Machtay M, Perry Y, Linden PA. Higher doses of neoadjuvant radiation for esophageal cancer do not affect the pathologic complete response rate or survival: a propensity-matched analysis. Ann Surg Oncol. 2020;27:500–8.

    Article  PubMed  Google Scholar 

  8. Yang Y, Xu X, Zhou X, Bao W, Zhang D, Gu F, et al. Impact of radiation dose on survival for esophageal squamous cell carcinoma treated with neoadjuvant chemoradiotherapy. Front Oncol. 2020;10:1431.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Yang H, Liu H, Chen Y, Zhu C, Fang W, Yu Z, et al. Neoadjuvant chemoradiotherapy followed by surgery versus surgery alone for locally advanced squamous cell carcinoma of the esophagus (NEOCRTEC5010): a phase III multicenter, randomized, open-label clinical trial. J Clin Oncol. 2018;36:2796–803.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Eyck BM, Van Lanschot JJB, Hulshof MCCM, Van Der Wilk BJ, Shapiro J, Van Hagen P, et al. Ten-year outcome of neoadjuvant chemoradiotherapy plus surgery for esophageal cancer: The randomized controlled CROSS trial. J Clin Oncol. 2021;39:1995–2004.

    Article  CAS  PubMed  Google Scholar 

  11. Huang TC, Hsu CH, Lin CC, Tu YK. Systematic review and network meta-analysis: neoadjuvant chemoradiotherapy for locoregional esophageal cancer. Jpn J Clin Oncol. 2015;45:1023–8.

    Article  PubMed  Google Scholar 

  12. Lee JG, Wu R. Erlotinib-cisplatin combination inhibits growth and angiogenesis through C-MYC and HIF-1 alpha in EGFR-mutated lung cancer in vitro and in vivo. Neoplasia. 2015;17:190–200.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Tsang RY, Al-Fayea T, Au HJ. Cisplatin overdose toxicities and management. Drug Saf. 2009;32:1109–22.

    Article  CAS  PubMed  Google Scholar 

  14. Marano L, D’Ignazio A, Cammillini F, Angotti R, Messina M, Marrelli D, et al. Comparison between 7th and 8th edition of AJCC TNM staging system for gastric cancer: old problems and new perspectives. Transl Gastroenterol Hepatol. 2019;4:22.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Sok M, Zavrl M, Greif B, Srpčič M. Objective assessment of WHO/ECOG performance status. Support Care Cancer. 2019;27:3793–8.

    Article  PubMed  Google Scholar 

  16. Cox JD, Stetz J, Pajak TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European-organization-for-research-and-treatment-of-cancer (EORTC). Int J Radiat Oncol Biol Phys. 1995;31:1341–6.

    Article  CAS  PubMed  Google Scholar 

  17. Dindo D, Demartines N, Clavien PA. Classification of surgical complications—a new proposal with evaluation in A cohort of 6336 patients and results of A survey. Ann Surg. 2004;240:205–13.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Cong MH, Li SL, Cheng GW, Liu JY, Song CX, Deng YB, et al. An interdisciplinary nutrition support team improves clinical and hospitalized outcomes of esophageal cancer patients with concurrent chemoradiotherapy. Chin Med J (Engl). 2015;128:3003–7.

    Article  CAS  PubMed  Google Scholar 

  19. Riccardi D, Allen K. Nutritional management of patients with esophageal and esophagogastric junction cancer. Cancer Control J Moffitt Cancer Cent. 1999;6:64–72.

    Article  CAS  Google Scholar 

  20. Bunting D, Berrisford R, Wheatley T, Humphreys L, Ariyarathenam A, Sanders G. Prospective cohort study of neoadjuvant therapy toxicity in the treatment of oesophageal adenocarcinoma. Int J Surg. 2018;52:126–30.

    Article  PubMed  Google Scholar 

  21. Cunningham D, Allum WH, Stenning SP, Thompson JN, Van De Velde CJH, Nicolson M, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355:11–20.

    Article  CAS  PubMed  Google Scholar 

  22. Kelsen DP, Winter KA, Gunderson LL, Mortimer J, Estes NC, Haller DG, et al. Long-term results of RTOG Trial 8911 (USA intergroup 113): a random assignment trial comparison of chemotherapy followed by surgery compared with surgery alone for esophageal cancer. J Clin Oncol. 2007;25:3719–25.

    Article  PubMed  Google Scholar 

  23. Bancewicz J, Clark PI, Smith DB, Donnelly RJ, Fayers PM, Weeden S. Surgical resection with or without preoperative chemotherapy in oesophageal cancer: a randomised controlled trial. Lancet. 2002;359:1727–33.

    Article  Google Scholar 

  24. Tu L, Sun L, Xu Y, Wang Y, Zhou L, Liu Y, et al. Paclitaxel and cisplatin combined with intensity-modulated radiotherapy for upper esophageal carcinoma. Radiat Oncol. 2013;8:75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Zhang J, Peng F, Li N, Liu Y, Xu Y, Zhou L, et al. Salvage concurrent radio-chemotherapy for post-operative local recurrence of squamous-cell esophageal cancer. Radiat Oncol. 2012;7:93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Ai D, Ye J, Wei S, Li Y, Luo H, Cao J, et al. Comparison of 3 paclitaxel-based chemoradiotherapy regimens for patients with locally advanced esophageal squamous cell cancer: a randomized clinical trial. JAMA Netw Open. 2022;5:e220120.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Chen J, Su T, Lin Y, Wang B, Li J, Pan J, et al. Intensity-modulated radiotherapy combined with paclitaxel and platinum treatment regimens in locally advanced esophageal squamous cell carcinoma. Clin Transl Oncol. 2018;20:411–9.

    Article  CAS  PubMed  Google Scholar 

Download references


We thanked Professor Jinyi Lang and Professor Tao Li, Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China for their general support.


This work was supported by the Science and Technology Department of Sichuan Province (2020YFH0169, 2023YFS0488 and 2023YFQ0055), Sichuan Province Clinical Key Specialty Construction Project.

Author information

Authors and Affiliations



LJ: Data collection, statistics, original draft. JZ: Conceptualization, review and editing the manuscript. YW: conducted the data analysis and developed the tracking and data collection programs. XC, LW, GW: data collection. YH, XL, LP: Executed esophagectomy. QW and LP: Monitor the clinical trial. All authors read and approved the final manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Lin Peng or Qifeng Wang.

Ethics declarations

Ethics approval and consent to participate

According to the ethical guide-lines of the Helsinki Declaration and was approved by the institutional review board of Sichuan Cancer Hospital & Institute. Written informed consents were obtained from all patients prior to treatment.

Consent for publication

All patients provided written informed consent.

Competing interests

The authors declare no confict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The original online version of this article was revised: Li Jiang was incorrectly denoted as a corresponding author.

Supplementary Information

Additional file 1.

sTable 1. Comorbidities of the study population. sTable 2. Clinical pathological characteristics. sTable 3. All grades of major toxicities. sTable 4. Overall survival (OS) and disease-free survival (DFS) survival patients receiving TC or TP regimen.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jiang, L., Zhu, J., Chen, X. et al. Safety and efficacy of paclitaxel plus carboplatin versus paclitaxel plus cisplatin in neoadjuvant chemoradiotherapy for patients with locally advanced esophageal carcinoma: a retrospective study. Radiat Oncol 17, 218 (2022).

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: