Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.17 Panjiayuan Nanli, Chaoyang District, 100021, Beijing, China.
Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.17 PanjiayuanNanli, Chaoyang District, 100021, Beijing, China.
Strahlenther Onkol. 2024 Dec;200(12):1038-1046. doi: 10.1007/s00066-024-02286-8. Epub 2024 Aug 12.
To evaluate the efficacy and safety of nab-paclitaxel plus cisplatin as the regimen of conversional chemoradiotherapy (cCRT) in locally advanced borderline resectable or unresectable esophageal squamous cell carcinoma (ESCC).
Patients with locally advanced ESCC (cT3‑4, Nany, M0‑1, M1 was limited to lymph node metastasis in the supraclavicular area) were enrolled. All the patients received the cCRT of nab-paclitaxel plus cisplatin. After the cCRT, those resectable patients received esophagectomy; those unresectable patients continued to receive the definitive chemoradiotherapy (dCRT). The locoregional control (LRC), overall survival (OS), event-free survival (EFS), distant metastasis free survival (DMFS), pathological complete response (pCR), R0 resection rate, adverse events (AEs) and postoperative complications were calculated.
45 patients with ESCC treated from October 2019 to May 2021 were finally included. The median follow-up time was 30.3 months. The LRC, OS, EFS, DMFS at 1 and 2 years were 81.5%, 86.6%, 64.3%, 73.2 and 72.4%, 68.8%, 44.8%, 52.7% respectively. 21 patients (46.7%) received conversional chemoradiotherapy plus surgery (cCRT+S). The pCR rate and R0 resection rate were 47.6 and 84.0%. The LRC rate at 1 and 2 years were 95.0%, 87.1% in cCRT+S patitents and 69.3%, 58.7% in dCRT patients respectively (HR, 5.14; 95%CI, 1.10-23.94; P = 0.021). The toxicities during chemoradiotherapy were tolerated, and the most common grade 3-4 toxicitiy was radiation esophagitis (15.6%). The most common postoperative complication was pleural effusion (38.1%) and no grade ≥ IIIb complications were observed.
nab-paclitaxel plus cisplatin are safe as the regimen of conversional chemoradiotherapy of ESCC.
评估nab-紫杉醇联合顺铂作为局部晚期可切除或不可切除食管鳞癌（ESCC）标准放化疗（cCRT）方案的疗效和安全性。
入组局部晚期 ESCC（cT3-4，Nany，M0-1，M1仅限于锁骨上区域淋巴结转移）患者。所有患者均接受 nab-紫杉醇联合顺铂的 cCRT。cCRT 后，可切除患者接受食管切除术；不可切除患者继续接受根治性放化疗（dCRT）。计算局部区域控制（LRC）、总生存（OS）、无事件生存（EFS）、无远处转移生存（DMFS）、病理完全缓解（pCR）、R0 切除率、不良事件（AEs）和术后并发症。
最终纳入 2019 年 10 月至 2021 年 5 月治疗的 45 例 ESCC 患者。中位随访时间为 30.3 个月。1 年和 2 年的 LRC、OS、EFS、DMFS 分别为 81.5%、86.6%、64.3%、73.2%和 72.4%、68.8%、44.8%、52.7%。21 例（46.7%）患者接受标准放化疗加手术（cCRT+S）。pCR 率和 R0 切除率分别为 47.6%和 84.0%。cCRT+S 患者 1 年和 2 年的 LRC 率分别为 95.0%和 87.1%，dCRT 患者分别为 69.3%和 58.7%（HR，5.14；95%CI，1.10-23.94；P=0.021）。放化疗期间的毒性反应可耐受，最常见的 3-4 级毒性为放射性食管炎（15.6%）。最常见的术后并发症是胸腔积液（38.1%），未观察到≥IIIb 级并发症。
nab-紫杉醇联合顺铂作为 ESCC 标准放化疗方案是安全的。
