| Objective:To compare the efficacy of and adverse reactions to taxane/platinum（TP）and fluorouracil/platinum（FP）combined with definitive chemoradiotherapy for esophageal squamous cell carcinoma（ESCC）.Methods:Retrospective analysis of patients with stage Ⅱ-Ⅳa esophageal squamous cell carcinoma who received radical concurrent chemoradiotherapy in the Radiotherapy Department of the The First Affiliated Hospital of Bengbu Medical College from 2014 to2017.Seventy-eight patients received taxane/cisplatin（TP group）chemotherapy,and 111 patients received fluorouracil/cisplatin（FP group）chemotherapy.After 1:1 propensity score matching for prognostic factors such as age,gender,KPS score,tumor location,tumor length,TNM stage,bilateral lung V20,V30 and other prognostic factors for esophageal squamous cell carcinoma,the baseline conditions of the two groups were basically balanced,and finally 122 patients were found.were included in the analysis.The Kaplan-Meier method was used to compare the overall survival（OS）and progression-free survival（PFS）of the TP group and the FP group,and the Log-rank test was used to compare the differences between the groups.Chi-square test was used to compare the incidence of adverse reactions between groups.Results:The disease control rate（DCR）of TP group and FP group were 96.7% and91.8%,respectively（P=0.439）.The median OS was 30 months（95%CI: 22.4-35.7months）and 23.5 months（95%CI: 15.1-31.9 months）in the TP and FP groups,respectively.The 1-,3-,and 5-year survival rates in the TP group were 80.3%,44.3%,and 40.9%,and in the FP group were 72.1%,40.4%,and 33.0%（P=0.399）.Median PFS was 20 months（95% CI: 13.6-26.4 months）and 16 months（95% CI: 9.3-22.7 months）in the TP and FP groups.The 1-,3-,and 5-year progression-free survival rates were 67.2%,38.4%,and 34.6% in the TP group,and 54.1%,32.5%,and 28.9% in the FP group（P=0.292）.Further subgroup analysis was performed on patients with different stages.In patients with stage Ⅱ-Ⅲ,the median OS of TP group and FP group were 33.5 months and 37.5 months,respectively,and the difference was not statistically significant.In patients with stage Ⅳa,the median OS of the TP group was 27.5 months,which was significantly higher than that of the FP group of 14.0 months（P=0.042）.Univariate analysis showed that the prognostic factors of OS and PFS were age,T stage,N stage,and clinical stage of tumor（P=0.007,0.029,0.002,0.000 and 0.009,0.003,0.002,0.000）.Factors such as patient age,tumor location,T stage,N stage,and clinical tumor stage were further incorporated into the Cox model for multivariate analysis.The results showed that clinical tumor stage was an independent prognostic factor affecting OS and PFS（all P<0.05）.In terms of adverse reactions,the incidences of hematological toxicity（P=0.003）and radiation dermatitis（P=0.032）in the TP group were higher than those in the FP group,while radiation esophagitis（P=0.548）and vomiting（P=0.205）occurred in the FP group.and esophageal perforation（P=0.163）and other adverse reactions increased slightly.Conclusions:TP regimen and FP regimen combined with radical concurrent radiotherapy have similar curative effects on patients with stage Ⅱ-Ⅲ esophageal squamous cell carcinoma,but TP regimen can significantly prolong the overall survival of patients with stage Ⅳa,and has a tendency to improve the progression-free survival of patients with stage Ⅳa.In terms of adverse reactions,the risk of hematological adverse reactions and radiation dermatitis in the TP group was slightly higher than that in the FP group. |
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