Zhang Tian-Wei, Zhang Peng, Nie Dong, Che Xin-Yu, Fu Tian-Tai, Zhang Yan
Department of Hematology and Radiotherapy, Zibo 148 Hospital, Zibo 255300, Shandong Province, China.
World J Gastrointest Oncol. 2023 Jul 15;15(7):1262-1270. doi: 10.4251/wjgo.v15.i7.1262.
Although the current conventional treatment strategies for esophageal carcinoma (EC) have been proven effective, they are often accompanied by serious adverse events. Therefore, it is still necessary to continue to explore new therapeutic strategies for EC to improve the clinical outcome of patients.
To elucidate the clinical efficacy of concurrent chemoradiotherapy (CCRT) with thalidomide (THAL) and S-1 (tegafur, gimeracil, and oteracil potassium capsules) in the treatment of EC as well as its influence on serum tumor markers (STMs).
First, 62 patients with EC treated at the Zibo 148 Hospital between November 2019 and November 2022 were selected and grouped according to the received treatment. Among these, 30 patients undergoing CCRT with cis-platinum and 5-fluorouracil were assigned to the control group (Con), and 32 patients receiving CCRT with THAL and S-1 were assigned to the research group (Res). Second, inter-group comparisons were carried out with respect to curative efficacy, incidence of drug toxicities, STMs [carbohydrate antigen 125 (CA125) and macrophage inflammatory protein-3α (MIP-3α)], angiogenesis-related indicators [vascular endothelial growth factor (VEGF); VEGF receptor-1 (VEGFR-1); basic fibroblast growth factor (bFGF); angiogenin-2 (Ang-2)], and quality of life (QoL) [QoL core 30 (QLQ-C30)] after one month of treatment.
The analysis showed no statistical difference in the overall response rate and disease control rate between the two patient cohorts; however, the incidences of grade I-II myelosuppression and gastrointestinal reactions were significantly lower in the Res than in the Con. Besides, the post-treatment CA125, MIP-3α, VEGF, VEGFR-1, bFGF, and Ang-2 Levels in the Res were markedly lower compared with the pre-treatment levels and the corresponding post-treatment levels in the Con. Furthermore, more evident improvements in QLQ-C30 scores from the dimensions of physical, role, emotional, and social functions were determined in the Res.
The above results demonstrate the effectiveness of THAL + S-1 CCRT for EC, which contributes to mild side effects and significant reduction of CA125, MIP-3α, VEGF, VEGFR-1, bFGF, and Ang-2 Levels, thus inhibiting tumors from malignant progression and enhancing patients' QoL.
尽管目前食管癌（EC）的传统治疗策略已被证明有效，但它们往往伴随着严重的不良事件。因此，仍有必要继续探索食管癌的新治疗策略，以改善患者的临床结局。
阐明沙利度胺（THAL）联合S-1（替吉奥胶囊）同步放化疗（CCRT）治疗食管癌的临床疗效及其对血清肿瘤标志物（STMs）的影响。
首先，选取2019年11月至2022年11月在淄博148医院接受治疗的62例食管癌患者，并根据所接受的治疗进行分组。其中，30例接受顺铂和5-氟尿嘧啶同步放化疗的患者被分配到对照组（Con），32例接受沙利度胺联合S-1同步放化疗的患者被分配到研究组（Res）。其次，对两组患者治疗1个月后的疗效、药物毒性发生率、STMs[糖类抗原125（CA125）和巨噬细胞炎性蛋白-3α（MIP-3α）]、血管生成相关指标[血管内皮生长因子（VEGF）；VEGF受体-1（VEGFR-1）；碱性成纤维细胞生长因子（bFGF）；血管生成素-2（Ang-2）]以及生活质量（QoL）[QoL核心30量表（QLQ-C30）]进行组间比较。
分析显示，两个患者队列的总缓解率和疾病控制率无统计学差异；然而，研究组I-II级骨髓抑制和胃肠道反应的发生率明显低于对照组。此外，研究组治疗后的CA125、MIP-3α、VEGF、VEGFR-1、bFGF和Ang-2水平明显低于治疗前水平以及对照组相应的治疗后水平。此外，研究组在身体、角色、情感和社会功能维度上QLQ-C30评分的改善更为明显。
上述结果表明沙利度胺联合S-1同步放化疗治疗食管癌有效，有助于减轻副作用，显著降低CA125、MIP-3α、VEGF、VEGFR-1、bFGF和Ang-2水平，从而抑制肿瘤的恶性进展，提高患者的生活质量。
