Phase Ⅱ clinical study of paclitaxel and cisplatin combined with concurrent radiotherapy in the treatment of locally advanced esophageal squamous cell carcinoma

doi:10.3760/cma.j.issn.1673-422X.2017.10.004

Abstract

Abstract: ObjectiveTo study the phase Ⅱ clinical efficacy of paclitaxel and cisplatin combined with concurrent radiotherapy in the treatment of locally advanced esophageal squamous cell carcinoma. MethodsSixtythree cases of locally advanced esophageal squamous cell carcinoma patients were selected from January 2014 to January 2016 in our hospital. All patients were randomly divided into the study group (32 cases) and control group (31 cases) according to random number table method. All patients were treated with threedimensional conformal radiotherapy, the control group was treated with 5fluorouracil and cisplatin, and study group was treated with paclitaxel combined with cisplatin, 21 days for a course of treatment, continuous 2 cycles of chemotherapy. The therapeutic effects and adverse reactions of the two groups of patients were evaluated. The levels of tumor markers such as carcino embryonic antigen (CEA), CA125 and CA50 were detected in the two groups before and after chemotherapy. The patients were followed up, and the survival rates were recorded. ResultsThe effective rate of the patients in the study group was 93.75%, higher than that of the control group (74.19%, χ2=4.510, P=0.034). Compared with the control group, the radiation esophagitis (Z=2.076, P=0.038), neurotoxicity (Z=3.806, P＜0.001), gastrointestinal reactions (Z=2.374, P=0.018), leukopenia (Z=1.979, P=0.048) were significantly lighter in the study group. After chemotherapy, the levels of CEA, CA125, CA50 of study group and control group were significantly lower than those before chemotherapy (all P＜0.05), and the levels of study group after chemotherapy were significantly lower than those of the control group (all P＜0.05). The 1year survival rate of the patients in the study group was 90.63%, which was significantly higher than that in the control group (70.97%), and the difference was statistically significant (χ2=4.287, P=0.038). ConclusionPaclitaxel and cisplatin combined with concurrent radiotherapy can improve the phase Ⅱ therapeutic effect of locally advanced esophageal squamous cell carcinoma, the toxicity of chemotherapy in patients is low, effectively improve the shortterm survival rate, with better clinical value.

Key words: Esophageal neoplasms, Treatment outcome, Cisplatin, Paclitaxel

An Cheng, Zhang Huanjiang. Phase Ⅱ clinical study of paclitaxel and cisplatin combined with concurrent radiotherapy in the treatment of locally advanced esophageal squamous cell carcinoma[J]. Journal of International Oncology, 2017, 44(10): 736-739.

References

［1］张思维, 张敏, 李光琳, 等. 20032007年中国食管癌发病与死亡分析［J］. 中国肿瘤, 2012, 21(4): 241247. ［2］强勇, 杨楠, 董国华, 等. 紫杉醇联合顺铂新辅助化疗对Ⅲ期食管癌手术风险及预后的影响［J］. 临床肿瘤学杂志, 2016, 21(2): 166169. ［3］薛亮, 王群, 谭黎杰, 等. 紫杉类联合奥沙利铂作为新辅助化疗治疗局部晚期食管鳞癌［J］. 复旦学报: 医学版, 2013, 40(3): 371374. DOI: 10.3969/j.issn.16728467.2013.03.024. ［4］ Edge SB, Compton CC. The American joint committee on cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM［J］. Ann Surg Oncol, 2010, 17(6): 14711474. DOI: 10.1245/s1043401009854. ［5］ Hasegawa S, Yoshikawa T, Aoyama T, et al. Esophagus or stomach? The seventh TNM classification for Siewert type Ⅱ/Ⅲ junetional adenocarcinoma［J］. Ann Surg Oncol, 2013, 20(3): 773779. DOI: 10.1245/s104340122780x. ［6］杨学宁, 吴一龙. 实体瘤治疗疗效评价标准RECIST［J］. 循证医学, 2004, 4(2): 8590. DOI: 10.3969/j.issn.16715144.2004.02.012. ［7］尹雪, 刘杰, 田金徽. 紫杉醇联合顺铂同步放化疗治疗中晚期食管癌的Meta分析［J］. 肿瘤防治研究, 2012, 39(7): 851854. DOI: 10.3971/j.issn.10008578.2012.07.022. ［8］陆寓非, 孙亚楠, 郑晓丽, 等. 食管鳞癌新辅助放化疗术后化疗疗效分析［J］. 中华肿瘤防治杂志, 2015, 22(6): 457462. ［9］ Hong JC, Murphy JD, Wang SJ, et al. Chemoradiotherapy before and after surgery for locally advanced esophageal cancer: a SEERMedicare analysis［J］. Ann Surg Oncol, 2013, 20(12): 39994007. DOI: 10.1245/s1043401330729. ［10］ van Hagen P, Hulshof M, Van Lanschot J, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer［J］. N Engl J Med, 2012, 366(22): 20742084. DOI: 10.1056/NEJMoa1112088. ［11］杨林, 王金万, 石远凯. 含铂化疗方案治疗晚期食管鳞癌疗效及预后分析［J］. 中华医学杂志, 2011, 91(18): 12331237. DOI: 10.3760/cma.j.issn.03762491.2011.18.003. ［12］王涛, 张申锋, 王磊. 紫杉醇24小时持续静脉滴注治疗晚期食管癌［J］. 中华医学杂志, 2010, 90(28): 19861988. DOI: 10.3760/cma.j.issn.03762491.2010.28.012.

[1]	Qian Xiaotao, Shi Ziyi, Hu Ge, Wu Xiaowei. Efficacy of consolidation chemotherapy after radical radiotherapy and chemotherapy for stage Ⅲ-ⅣA esophageal squamous cell carcinoma： a real-world clinical study [J]. Journal of International Oncology, 2024, 51(6): 326-331.
[2]	Yang Mi, Bie Jun, Zhang Jiayong, Deng Jiaxiu, Tang Zuge, Lu Jun. Analysis of the efficacy and prognosis of neoadjuvant therapy for locally advanced resectable esophageal cancer [J]. Journal of International Oncology, 2024, 51(6): 332-337.
[3]	Liu Jing, Liu Qin, Huang Mei. Prognostic model construction of lung infection in patients with chemoradiotherapy for esophageal cancer based on SMOTE algorithm [J]. Journal of International Oncology, 2024, 51(5): 267-273.
[4]	Wang Kun, Zhou Zhongxin, Zang Qiwei. Predictive value of serum TGF-β1 and VEGF levels in patients with non-small cell lung cancer after single-port thoracoscopic radical resection [J]. Journal of International Oncology, 2024, 51(4): 198-203.
[5]	Wan Fang, Yang Gang, Li Rui, Wan Qijing. Expression levels and clinical significance of serum miR-497 and miR-383 in patients with esophageal cancer [J]. Journal of International Oncology, 2024, 51(4): 204-209.
[6]	Yan Aiting, Wang Cuizhu, Liu Chungui, Lu Xiaomin. Clinical efficacy and safety of camrelizumab and sintilimab in the treatment of advanced non-small cell lung cancer [J]. Journal of International Oncology, 2024, 51(3): 137-142.
[7]	Gong Yan, Chen Honglei. Research progress on the mechanism of microRNA regulation of cisplatin resistance in ovarian cancer [J]. Journal of International Oncology, 2024, 51(3): 186-190.
[8]	Jiang Xi, Wu Yongcun, Liang Yan, Chu Li, Duan Yingxin, Wang Lijun, Huo Junjie. Impact of pembrolizumab combined with chemotherapy on angiogenesis and circulating endothelial cells in patients with advanced non-small cell lung cancer [J]. Journal of International Oncology, 2024, 51(2): 89-94.
[9]	Gao Xinyu, Li Zhenjiang, Sun Hongfu, Han Dan, Zhao Qian, Liu Chengxin, Huang Wei. Clinical application of MR-guided radiotherapy based on MR-linac in esophageal cancer patients [J]. Journal of International Oncology, 2024, 51(1): 37-42.
[10]	Shandong Medical Association Multidisciplinary Joint Committee on Lung Cancer. Shandong Provincial Medical Association multidisciplinary standardized diagnosis and treatment guidelines for esophageal carcinoma （2023 Edition） [J]. Journal of International Oncology, 2023, 50(7): 385-397.
[11]	Zhang Jinnan, Liu Bangqing, Li Jun, Liu Xiaohui. Research on BHLHE40 targets HMGA2 to reduce the sensitivity of thyroid cancer cells to cisplatin through activating the oxidative phosphorylation pathway [J]. Journal of International Oncology, 2023, 50(7): 398-406.
[12]	Zhou Ting, Xu Shaohua, Mei Lin. Efficacy and safety of bevacizumab combined with capecitabine in the treatment of advanced breast cancer [J]. Journal of International Oncology, 2023, 50(3): 144-149.
[13]	Cao Mengqing, Xu Zhiyong, Shi Yuting, Wang Kai. Role of tertiary lymphoid structures in tumor immune microenvironment regulation and anti-tumor therapy [J]. Journal of International Oncology, 2023, 50(3): 169-173.
[14]	Ji Shiyu, Zhang Mingxin, Xie Huahong, Bai Yuan, Wang Tong. Observation on the efficacy of different stents in the treatment of patients with advanced esophageal cancer [J]. Journal of International Oncology, 2023, 50(2): 76-81.
[15]	Gong Heyi, Yi Yan, Zhang Jian, Li Baosheng. Management strategies for locally advanced operable esophageal carcinoma achieving clinical complete response after neoadjuvant chemoradiotherapy [J]. Journal of International Oncology, 2023, 50(12): 745-750.