Abstract:
Objective To analyze the clinical efficacy and adverse reactions of precise radiotherapy concurrent cisplatin or cisplatin combined with paclitaxel liposome chemotherapy in patients with locally advanced esophageal squamous cell carcinoma.
Methods The retrospective data of 46 patients with locally advanced esophageal squamous cell carcinoma were collected. The patients were treated with precise radiotherapy concurrent with cisplatin-based chemotherapy. Twenty-six cases were delivered single agent cisplatin chemotherapy (RT+P group), 20 cases cisplatin combined with paclitaxel liposome chemotherapy (RT+TP group). The 1, 2, 3-year survival rates and the incidences of irradiation-induced esophagitis, pneumonia, gastrointestinal tract reaction and myelosuppression were assessed. The results were compared with those of 17 cases treated with radiotherapy alone (RT group).
Results No grade Ⅳ-Ⅴ adverse reaction was observed in all the three groups. Only about 12%-15% patients in the three groups presented radiation pneumonia with low incidence and slight severity. There were no significant differences between the three groups (P=0.939). Mild adverse reaction of RT group was observed, of which grade Ⅰ-Ⅱ gastrointestinal tract reaction and grade Ⅲ myelosuppression were significantly lower than those in other groups. The response rates of RT+P and RT+TP groups were higher than that of RT group, however the difference was not significant (P=0.161). The 1, 2, 3-year survival rates and median survival times of RT+P and RT+TP groups were higher than those of RT group. The survival rate of RT+TP group was significantly better than that of RT group (P=0.019).
Conclusion The better treatment effect and survival benefit could be obtained by precise radiotherapy concurrent with cisplatin combined with paclitaxel liposome chemotherapy for locally advanced esophageal squamous cell carcinoma, which was superior to radiotherapy alone remarkably.