Pre-existing neuropathies are not a contraindication to treatment. Central neurotoxicity may occur and may be severe especially with paclitaxel. Myalgia and/or arthralgia typically appear 2-3 days after drug administration, resolve within a few days, and are unrelated to dose (41),(42). Docetaxel-associated neuropathy occurs less frequently and with less severity than paclitaxel-associated neuropathy (42). Reversible fluid retention syndrome (42),(43), which is characterized by edema and third-space fluid retention, is a unique side effect of docetaxel. Bowel wall edema and pleural and peritoneal fluid retention are common manifestations of this syndrome, Inhibitors,research,lifescience,medical which

is caused by a docetaxel-induced increase in capillary permeability. The most Inhibitors,research,lifescience,medical serve end-organ complication of third-space fluid collection is heart failure. This severe complication can be ameliorated and prevented with prophylactic administration of corticosteroids, along with aggressive and early administration of diuretics (43). No less important, but less frequently reported, toxicities associated with taxanes include fatigue, mucositis,

Inhibitors,research,lifescience,medical gastrointestinal symptoms, phlebitis, drug-induced adult respiratory distress syndrome (for docetaxel), and bradycardia plus swollen, red, painful mouth (for paclitaxel). Fatigue is observed in 58-67% of the patients treated with docetaxel, and it is occasionally severe enough to cause a modification in dose (33). Mucositis typically results from slow infusion, and it occurs more frequently in patients treated with docetaxel than with paclitaxel. Although less-severe gastrointestinal toxicityties, such as nausea, vomiting, and diarrhea, also occur more frequently Inhibitors,research,lifescience,medical with docetaxel, grade 3/4 gastrointestinal toxicities are uncommon (42). Table 1 summarizes the rare adverse effects associated taxanes. Table 1 Rare side effects associated

with taxanes Clinical use of taxanes in the treatment/management of advanced gastroesophageal cancers For many solid Inhibitors,research,lifescience,medical tumors, tumor responses and survival outcomes are higher with CRT than with radiotherapy (RT) alone (44)-(49). For patients with solid tumors, CRT is used to palliate symptoms, treat Oligomycin A purchase definitively, and contribute significantly to multimodality therapy. Chemotherapeutic agents have been Sodium butyrate successfully used as radiosentisizers; platinums, fluoropyrimidines, and taxanes are the most commonly used chemotherapeutic agents. The results of the Radiation Therapy Oncology Group (RTOG) 85-01 trial (49) established that local disease control and survival outcome were both improved with CRT (RT combined with cisplatin and 5-FU) compared with RT alone. Therefore, most large randomized studies of CRT in GECs have been designed with either 5-FU, cisplatin, or both as radiosensitizers. Although taxanes are used as part of CRT for GECs, their use as radiosensitizers has been limited to phase II single-arm studies of patients with both resectable and locally advanced (unresectable) disease (50).