Second-line chemotherapy for esophageal squamous cell carcinoma: Efficiency and survival analysis of 213 cases

Objective: To investigate the efficacy and safety of different regimens as second-line chemotherapy in patients with esophageal squamous cell carcinoma (ESCC). Methods: According to different second-line chemotherapy regimens, 213 patients with ESCC were divided into four groups: docetaxel group, paclitaxel group, gemcitabine group and irinotecan group. The response and survival were retrospectively analyzed. The log-rank test and COX proportional hazard model were used for univariate and multivariate analyses of prognosis-related factors. Results: The objective response rates (ORRs) of docetaxel group, paclitaxel group, gemcitabine group and irinotecan group were 30.9%, 25.0%, 19.5% and 11.4%, respectively (P = 0.113), and the disease control rates (DCRs) were 56.7%, 52.5%, 51.2% and 45.7%,  respectively (P = 0. 721); the median progression-free survival time were 3.0, 2.1, 2.7 and 1.5 months, respectively, and the median survival time were 7.6, 7.9, 7.7 and 7.2 months, respectively. The progression-free survival and overall survival were not significantly different among the four groups (P = 0.240, P = 0.094). ECOG performance status score and response to first-line chemotherapy were independent prognostic factors for second-line chemotherapy in ESCC patients in multivariate analysis (both P < 0.05). Conclusion: Docetaxel, paclitaxel, gemcitabine or irinotecan-based second-line chemotherapy can exert similar efficiency for advanced ESCC and the adverse effects can be tolerable. ECOG performance status score and response to first-line chemotherapy are independent prognostic factors. DOI:10.3781/j.issn.1000-7431.2016.33.313