新辅助放疗联合紫杉醇和顺铂同步化疗与其他铂类化疗方案治疗胸段食管鳞状细胞癌的安全性和疗效分析

Safety and efficacy analysis of neoadjuvant radiotherapy combined with concurrent paclitaxel plus nedaplatin versus other platinum-based chemotherapy for thoracic segmental esophageal squamous cell carcinoma.

作者信息

Zhuang Qingyang, Li Hui, Tang Lirui, Zheng Hongying, Li Jiancheng, Wu Junxin, Li Jinluan

机构信息

Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.

Department of Oncology, Fuzhou Pulmonary Hospital of Fujian, Fuzhou, China.

出版信息

Front Oncol. 2025 May 13;15:1582481. doi: 10.3389/fonc.2025.1582481. eCollection 2025.

DOI:10.3389/fonc.2025.1582481

PMID:40432925

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12106031/

Abstract

BACKGROUND

Esophageal cancer is among the leading causes of cancer-related mortality in males. This study aimed to evaluate the efficacy and safety of nedaplatin (NDP) in comparison to other platinum-based (OPB) agents combined with paclitaxel and concurrent neoadjuvant radiotherapy for locally advanced thoracic segmental esophageal squamous cell carcinoma (ESCC).

METHODS

This single-center, retrospective cohort study was conducted in China. The primary endpoints of this study were safety and efficacy assessments. Unpaired t-tests, chi-squared tests, and Fisher's exact tests were used to compare intergroup differences, as appropriate. Multivariate logistic regression models were used to explore the associations between postoperative outcomes and the two treatment groups. Kaplan-Meier survival curves and Cox proportional hazards regression models based on OS and PFS were used to compare the efficacy between the two groups.

RESULTS

A total of 212 patients were enrolled in this retrospective cohort study, including 79 who received NDP and 133 who received OPB (82 were treated with cisplatin, 20 with carboplatin, 19 with lobaplatin, and 12 with oxaliplatin) agents. The incidences of grade 3-4 acute radiotherapy-associated esophagitis, pneumonitis, and leukemia were significantly lower in the NDP group than in the OPB group (p = 0.02, p < 0.001, and p = 0.002, respectively). All grades of acute gastrointestinal reactions, including nausea, vomiting, anorexia, and diarrhea, were significantly more frequent in the OPB group than in the NPD group (p < 0.001, p = 0.032, p < 0.001, and p = 0.002, respectively). The Kaplan-Meier curves for overall survival (OS) and progression-free survival (PFS) showed similar results for both groups.

CONCLUSIONS

The safety profile of nedaplatin may be superior to those of other platinum-based agents in terms of acute radiotherapy toxicity and postoperative side effects; however, there was no difference in the efficacy between the two groups regarding short-term prognostic tumor regression grades or long-term OS and PFS.

摘要

背景

食管癌是男性癌症相关死亡的主要原因之一。本研究旨在评估奈达铂（NDP）与其他铂类药物（OPB）联合紫杉醇及同步新辅助放疗治疗局部晚期胸段食管鳞状细胞癌（ESCC）的疗效和安全性。

方法

本单中心回顾性队列研究在中国进行。本研究的主要终点是安全性和疗效评估。根据情况，使用非配对t检验、卡方检验和Fisher精确检验来比较组间差异。使用多因素逻辑回归模型来探索术后结果与两个治疗组之间的关联。基于总生存期（OS）和无进展生存期（PFS）的Kaplan-Meier生存曲线和Cox比例风险回归模型用于比较两组之间的疗效。

结果

本回顾性队列研究共纳入212例患者，其中79例接受NDP治疗，133例接受OPB治疗（82例接受顺铂治疗，20例接受卡铂治疗，19例接受洛铂治疗，12例接受奥沙利铂治疗）。NDP组3-4级急性放疗相关食管炎、肺炎和白细胞减少症的发生率显著低于OPB组（分别为p = 0.02、p < 0.001和p = 0.002）。OPB组所有级别的急性胃肠道反应，包括恶心、呕吐、厌食和腹泻，均显著高于NPD组（分别为p < 0.001、p = 0.032、p < 0.001和p = 0.002）。总生存期（OS）和无进展生存期（PFS）的Kaplan-Meier曲线显示两组结果相似。