Mathewos AssefaSonia WorkuIkram Musa2026-06-182026-06-182025-12-01https://etd.aau.edu.et/handle/123456789/8217Background: Esophageal Squamous Cell Carcinoma (ESCC) Is One of the Most Common Sub-Types of Esophageal Cancer in Sub-Saharan Africa. The Majority of Patients Present with Unresectable or Metastatic Disease Usually Accompanied with Malnourishment and Poor General Condition. FOLFOX And Carboplatin/Paclitaxel Are Used as First-Line Therapy for Advanced Diseases. Howev Er, There Is No Data on the Comparative Effectiveness and Safety of These Regimens Africa. Objective: To Compare the Treatment Outcome of FOLFOX Versus Carboplatin–Paclitaxel as First-Line Therapy for Advanced Squamous Cell Carcinoma of the Esophagus. Methods: Patients With Stage IV Esophageal Squamous Cell Carcinoma Treated Between Febru Ary 2023- February 2025 Who Met the Inclusion and Exclusion Criteria Who Were Included. Data Was Analyzed Using Descriptive Statistics, Kaplan-Meier Curves, Log-Rank Tests, And Multivariable Analysis to Compare Outcomes Between Treatment Groups. Results: A Total Of 55 Patients with Stage IV Esophageal Squamous Cell Carcinoma Were Include Ed, With A Median Age Of 56 Years. Thirty Patients (54.5%) Received Carboplatin–Paclitaxel And 25 (45.5%) Received FOLFOX. The Overall Response Rate Was Higher with Carboplatin–Paclitaxel Than FOLFOX At Both Mid-Cycle (67.9% Vs. 47.8%) And End-Cycle Assessments, With Greater Mean Tumor Reduction (66.3% Vs. 49.4%, P = 0.038). The Median Overall Survival (OS) For the Entire Cohort Was 9 Months (95% CI: 7.2–10.3), With A 1-Year OS Of 45%. Median OS Was 9.0 Months for Carboplatin–Paclitaxel And 8.0 Months For FOLFOX, With No Significant Difference Between Regimens (P = 0.286). Treatment-Related Toxicities Occurred In 52.7% Of Patients, Pre-Dominantly Hematologic. Grade 3–4 Neutropenia Was Observed In 10.9%. Severe Hematologic Toxicities Were More Common with Carboplatin–Paclitaxel (16.7% Vs. 4.0%), Whereas Peripheral Neuropathy Occurred More Frequently with FOLFOX (8.0% Vs. 0%).enEsophageal Squamous Cell CarcinomaResponse RateTreatment Related ToxicityFolfoxCarboplatin-PaclitaxelSurvivalThesis