Sun Xiaojiang, Han Shuiyun, Gu Feiying, Lin Gang, Wang Zhun, Wang Yuezhen, Xu Yaping
1. Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou China;
1. Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou China;; 2. Key Laboratory of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou 310022, China.
J Cancer. 2016 May 25;7(9):1066-73. doi: 10.7150/jca.13547. eCollection 2016.
To retrospectively compare taxane-based with fluorouracil-based chemoradiotherapy in terms of toxicity profiles, efficacy and survival in patients with inoperable esophageal cancer.
We analyzed retrospectively 179 consecutive patients who were unresectable or medically unfit for surgery between March 2009 and November 2014. Eight-three patients were included in the taxane group and 96 cases were in the fluorouracil group.
The overall response rate (ORR) in the taxane group was higher than fluorouracil group, but was not significantly different (71.6% vs. 63.5%, respectively, P=0.255). In total, 53.0% (44/83) of the patients in the taxane group had progressive disease versus 54.2% (52/96) in the fluorouracil group (not significantly different (P=0.758)). There was no significant difference in overall response rate, progression free survival and overall survival, as well as treatment-related death. In terms of non-hematological toxicity, patients in the taxane group experienced a lower incidence of ≥ grade 3 esophageal perforation or fistula (4.8% vs. 13.5%, P=0.047) and pneumonia (4.8% vs. 9.7%, P=0.242). Regarding hematological toxicity, thrombocytopenia in the taxane group was significantly lower (4.8% vs. 13.5%, P=0.047), but there was a trend towards a higher rate of ≥ grade 3 leukopenia (34.9% vs.26.0%, P=0.196).
Chemoradiation with taxane-based regimens is well tolerated, with potentially promising efficacy, and could become a good alternative treatment in a first line setting for patients with inoperable esophageal squamous cell carcinoma.
回顾性比较以紫杉烷为基础的化疗放疗与以氟尿嘧啶为基础的化疗放疗在不可切除食管癌患者中的毒性特征、疗效和生存率。
我们回顾性分析了2009年3月至2014年11月期间179例连续的不可切除或因医学原因不宜手术的患者。紫杉烷组纳入83例患者，氟尿嘧啶组纳入96例患者。
紫杉烷组的总缓解率（ORR）高于氟尿嘧啶组，但差异无统计学意义（分别为71.6%和63.5%，P = 0.255）。紫杉烷组共有53.0%（44/83）的患者疾病进展，氟尿嘧啶组为54.2%（52/96）（差异无统计学意义（P = 0.758））。在总缓解率、无进展生存期和总生存期以及治疗相关死亡方面，差异均无统计学意义。在非血液学毒性方面，紫杉烷组≥3级食管穿孔或瘘的发生率较低（4.8%对13.5%，P = 0.047），肺炎发生率也较低（4.8%对9.7%，P = 0.242）。在血液学毒性方面，紫杉烷组血小板减少症明显较低（4.8%对13.5%，P = 0.047），但≥3级白细胞减少症的发生率有升高趋势（34.9%对26.0%，P = 0.196）。
基于紫杉烷方案的化疗放疗耐受性良好，疗效可能有前景，可成为不可切除食管鳞状细胞癌患者一线治疗的良好替代方案。
