Department of Radiation Oncology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, 300, Guangzhou Road, Nanjing, Jiangsu, China.
Department of Radiation Oncology, school of Nanjing Medical University, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, 300, Guangzhou Road, Nanjing, Jiangsu, China.
Cancer Radiother. 2021 Feb;25(1):39-44. doi: 10.1016/j.canrad.2020.06.029. Epub 2021 Jan 6.
Chemoradiotherapy (CRT) is considered as a standard treatment for unresectable and inoperable esophageal cancer (EC) patients. However, no consensus has been reached regarding the optimal synchronous chemotherapy regimen and the best combination of radiotherapy and chemotherapy. The aim of this study was to evaluate the efficacy and toxicity of raltitrexed plus cisplatin and docetaxel plus cisplatin to find a safe and effective concurrent chemotherapy schedule.
Our retrospective study included 151 EC patients treated with raltitrexed and cisplatin (RP) (n=90) or docetaxel and cisplatin (DP) (n=61) from 2011 till 2018. Survival outcomes and treatment related toxicity were analyzed between the two groups.
PFS and OS were 18 and 34 months in the RP group, while 13 and 20 months in the DP group (P=0.118 and P=0.270). The 1-, 2-, 3-year survival rates of the RP group were 71.1, 55.4 and 46.4%. For the DP group, these were 63.9, 44.3 and 37.6%, respectively. Compared with DP group, RP group received a superior CR rate (68.9% versus 52.5%, P=0.041). There was a trend that the total number of toxic reactions in RP group was lower than that in DP group (P=0.058).
Even RP and DP groups have the similar survival outcomes and toxicity, raltitrexed/cisplatin get a higher complete response rate. Our study suggests that raltitrexed combined with cisplatin is a safe and effective concurrent chemotherapy regimen and it might be used as an alternative for cisplatin/5-FU and cisplatin/docetaxel in CCRT for EC patients.
放化疗（CRT）被认为是不可切除和不能手术的食管癌（EC）患者的标准治疗方法。然而，对于最佳同步化疗方案以及放疗和化疗的最佳组合尚未达成共识。本研究旨在评估雷替曲塞联合顺铂和多西他赛联合顺铂的疗效和毒性，以找到一种安全有效的同期化疗方案。
我们的回顾性研究纳入了 2011 年至 2018 年期间接受雷替曲塞和顺铂（RP）（n=90）或多西他赛和顺铂（DP）（n=61）治疗的 151 例 EC 患者。分析两组患者的生存结局和治疗相关毒性。
RP 组的 PFS 和 OS 分别为 18 个月和 34 个月，DP 组分别为 13 个月和 20 个月（P=0.118 和 P=0.270）。RP 组的 1、2、3 年生存率分别为 71.1%、55.4%和 46.4%。DP 组分别为 63.9%、44.3%和 37.6%。与 DP 组相比，RP 组的完全缓解率更高（68.9%比 52.5%，P=0.041）。RP 组的总毒性反应数量低于 DP 组，这一趋势具有统计学意义（P=0.058）。
即使 RP 组和 DP 组的生存结局和毒性相似，雷替曲塞/顺铂也能获得更高的完全缓解率。我们的研究表明，雷替曲塞联合顺铂是一种安全有效的同期化疗方案，可作为 EC 患者 CRT 中顺铂/5-FU 和顺铂/多西他赛的替代方案。
