Department of Surgery, School of Medicine, Toho University, Tokyo, Japan.
Department of Internal Medicine, School of Medicine, Toho University, Tokyo, Japan.
Ann Thorac Cardiovasc Surg. 2021 Aug 20;27(4):219-224. doi: 10.5761/atcs.oa.20-00294. Epub 2021 Jan 6.
To compare efficacy and safety of dual docetaxel/nedaplatin treatment versus docetaxel alone as second-line chemotherapy for advanced esophageal cancer.
In all, 36 patients with metastatic and/or recurrent esophagus squamous cell carcinoma resistant to first-line chemotherapy (fluorouracil/cisplatin) were recruited from 2011 to 2018 and randomized into two groups. Treatment response and survival were compared between the docetaxel/nedaplatin (60/80 mg/m/day) group and docetaxel (70 mg/m/day) group. Treatment was repeated every 3 weeks until tumor progression. Patients were followed up until March 2019 or death.
The frequency of Grade 3 or higher adverse events in the docetaxel/nedaplatin group (58.8%) was higher compared with the docetaxel group (26.3%) (P = 0.090). We found a treatment response rate of 52.9% and 36.8% and a median survival of 8.9 and 7.0 months in the docetaxel/nedaplatin-treated and docetaxel-treated group, respectively (P = 0.544).
No significant survival advantage was found for docetaxel/nedaplatin-treated patients, although there was an increased frequency of high-grade adverse events compared to docetaxel-treated patients. Because of the limited cohort size, a Phase III study based on our findings is not warranted to assess the clinical impact of docetaxel/nedaplatin treatment. This trial is registered with the University Hospital Medical Information Network (UMIN 000005877).
比较多西他赛/奈达铂与多西他赛单药二线治疗转移性和/或复发性食管鳞癌的疗效和安全性。
2011 年至 2018 年共纳入 36 例对一线化疗(氟尿嘧啶/顺铂)耐药的转移性和/或复发性食管鳞癌患者,并随机分为两组。比较多西他赛/奈达铂(60/80mg/m2/天)组和多西他赛(70mg/m2/天)组的治疗反应和生存情况。治疗每 3 周重复一次,直到肿瘤进展。患者随访至 2019 年 3 月或死亡。
多西他赛/奈达铂组(58.8%)的 3 级或 3 级以上不良事件发生率高于多西他赛组(26.3%)(P=0.090)。我们发现多西他赛/奈达铂组的治疗反应率为 52.9%,多西他赛组为 36.8%,中位生存时间分别为 8.9 个月和 7.0 个月(P=0.544)。
与多西他赛组相比,多西他赛/奈达铂组患者的生存优势并未显著增加,但高等级不良事件的发生率有所增加。由于队列规模有限,基于我们的研究结果,没有必要进行 III 期研究来评估多西他赛/奈达铂治疗的临床影响。该试验在大学医院医疗信息网络(UMIN 000005877)注册。