Cheraghi Aida, Barahman Maedeh, Hariri Ramyar, Nikoofar Alireza, Fadavi Pedram
Department of Radiotherapy, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran.
Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2021 Oct 25;35:140. doi: 10.47176/mjiri.35.140. eCollection 2021.
Neoadjuvant chemoradiation is one of the main treatment approaches in esophageal cancer treatment, which can improve outcomes of a patient with esophageal cancer. In the current study, we aimed to compare the response rate and side effects of 2 distinctive neoadjuvant chemoradiation protocols. The study was a randomized clinical trial that was performed on 70 patients with esophageal and gastroesophageal junction cancer in Iran. The study participants were randomly assigned to 1 of our treatment groups. The first group received capecitabine (625 mg/m/TID) and oxaliplatin (50 mg/m/weekly), while the second group was given a combination of carboplatin (AUC:2/weekly) and paclitaxel (75mg/m/weekly). Both groups were given weekly 50.4-54 Gy dose of RT. Chi square and Fisher exact tests have been used for data analysis. All statistical tests were performed using SPSS software Version 22.0 and the significance level was set at 0.05. Complete pathological response was detected in 18(51.4%) of patients in group I and 8 (22.8%) in group II (p=0.013). We also observed higher thrombocytopenia in CarTax arm 19 (54.2%) in comparison to CapOX arm 8(22.8%), and the difference was statistically significant (p=0.007). No statistical difference was found regarding neutropenia, fatigue, anorexia, esophagitis, and diarrhea. The CapOxRT regime provides more favorable outcomes and also it is more tolerated by patients.
新辅助放化疗是食管癌治疗的主要方法之一，可改善食管癌患者的治疗效果。在本研究中，我们旨在比较两种不同新辅助放化疗方案的缓解率和副作用。该研究是一项随机临床试验，对伊朗70例食管癌和食管胃交界癌患者进行。研究参与者被随机分配到我们的一个治疗组。第一组接受卡培他滨（625mg/m²，每日三次）和奥沙利铂（50mg/m²，每周一次），而第二组给予卡铂（AUC：2，每周一次）和紫杉醇（75mg/m²，每周一次）的联合用药。两组均接受每周50.4 - 54Gy剂量的放疗。采用卡方检验和Fisher精确检验进行数据分析。所有统计检验均使用SPSS软件22.0版进行，显著性水平设定为0.05。在第一组18例（51.4%）患者和第二组8例（22.8%）患者中检测到完全病理缓解（p = 0.013）。我们还观察到，与奥沙利铂联合卡培他滨组8例（22.8%）相比，卡铂联合紫杉醇组血小板减少症发生率更高，为19例（54.2%），差异具有统计学意义（p = 0.007）。在中性粒细胞减少、疲劳、厌食、食管炎和腹泻方面未发现统计学差异。奥沙利铂联合放疗方案提供了更有利的治疗效果，并且患者对其耐受性更好。
