A comparative study of the efficacy and safety between paclitaxel plus fluorouraci and cisplatin plus fluorouracil in the treatment of locally advanced esophageal squamous carcinoma
2018
Objective
To compare the efficacy and safety of two concurrent chemoradiotherapy regimens between paclitaxel plus fluorouracil(TF) and cisplatin plus fluorouracil (PF) in the treatment of locally advanced esophageal squamous carcinoma.
Methods
103 patients with locally advanced esophagus carcinoma were treated in Affiliated Hospital of Jiangnan University from December 2014 to February 2016, and randomly assigned to either study group (TF) or control group (PF) according to random number table, of which 52 patients in the TF group while 51 patients in the PF group. The primary outcome was overall survival(OS), and secondary outcomes include progression-free survival(PFS), local progression-free survival(LPFS) and side effects.
Results
The 1-year OS for TF group was 76.9% versus 74.5% for PF group(P>0.05), and the 2-year OS for TF group was 59.6% versus 56.9% for PF group(P>0.05). The 1-year LPFS for TF group and PF group were 71.2% and 66.7% respectively(P>0.05), and the 2-year LPFS for TF group and PF group were 61.5% and 58.8% respectively(P>0.05). The 1-year PFS for TF group was 63.5% versus 62.7% for PF group(P>0.05), and the 2-year PFS for TF group was 51.9% versus 39.2% for PF group(P>0.05). The incidence rate of serious (grade 3- 4) leukopenia for TF group was 36.5% versus 17.6% for PF group(χ2=4.642, P<0.05). The incidence rate of serious (grade 3-4) acute radiation pneumonitis was 15.4% in the TF group, higher than that in the PF group with the rate of 3.9%(χ2=3.859, P<0.05), while the incidence rate of severe nausea and vomiting for PF group was 17.6% versus 1.9% for TF group(χ2=7.262, P<0.05). The difference between the two groups was statistically significant.
Conclusions
Patients who were treated with two concurrent chemoradiotherapy regimens showed no difference in OS, PFS and LPFS. The regimen on the basis of Paclitaxel has higher risk of adverse effects incidence rates of hematological toxicity and acute radiation pneumonitis, while digestive system toxicity must be concerned when concurrent chemoradiotherapy is performed on the basis of cisplatin plus fluorouracil.
Key words:
Esophageal squamous carcinoma; Concurrent chemoradiotherapy; Efficiency; Side effects
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