Clinical Effect And Prognostic Factors Analysis Of Paclitaxel Liposome Combined Cisplatin For Advanced Esophageal Squamous Cell Carcinoma

Esophageal cancer is one of the common malignant tumors of digestive tract,and its morbidity and mortality are ranked 7th and 6th respectively in the world.There are regional differences in esophageal cancer,especially in China,which is a high incidence area of esophageal cancer in the world.Esophageal squamous cell carcinoma is the most common pathological type with poor prognosis in China.The reason lies in the lack of prominent clinical symptoms in early esophageal squamous cell carcinoma,resulting in the late diagnosis of most patients with esophageal squamous cell carcinoma.The 5-year survival rate of patients with esophageal squamous cell carcinoma after comprehensive treatment is often less than 30%.In the past,the commonly used first-line treatment regimen was "cisplatin+fluorouracil" regimen.The remission rate of this scheme is low,only 15%?45%,and the median survival time is usually less than 8 months.However,other first-line drugs such as paclitaxel and irinotecan are easy to cause severe allergic reactions and diarrhea.Therefore,it is of great significance to improve the existing treatment plan and find new therapeutic drugs for improving the cure rate of tumor and prolonging the survival time of patients.Paclitaxel liposome@ independently developed by China was marketed in 2003.The medicine effectively aims at the clinical defects of paclitaxel injection,and is then widely applied to the treatment of various major tumor types,such as ovarian cancer,breast cancer and non-small cell lung cancer.Many studies at home and abroad agree that paclitaxel liposome can effectively reduce the adverse reactions,but the number of subjects is often less than 50,and they have not continued to expand the sample size for exploration.ObjectiveThis study will take a large sample of research subjects to participate in the study,and further explore the clinical efficacy and adverse reactions of paclitaxel liposome combined with cisplatin in the first-line treatment of advanced esophageal squamous cell carcinoma.Data and methodsClinical data of 144 patients with advanced esophageal squamous cell carcinoma in the First Affiliated Hospital of Zhengzhou University from February 2015 to June 2018 were collected.The patients were divided into observation group and control group according to different treatment schemes.The observation group received paclitaxel liposome combined with cisplatin,while the control group received 5-fluorouracil combined with cisplatin.Relevant statistical methods such as chi-square test,survival analysis and COX multivariate regression analysis were used to compare the short-term and long-term efficacy,adverse reactions and factors affecting prognosis of two groups of patients.ResultsShort-term curative effect:the effective rate of the observation group(36.4%)is slightly higher than that of the control group(26.7%),but there is no significant difference between the two groups(?2=1.309,P=0.253).Long-term efficacy:The median overall survival time(10.3 months)and median disease-free survival time(5.6 months)of patients in the observation group are significantly higher than those in the control group(7.8 months)and median disease-free survival time(4.1 months).The difference between the overall survival time of the two groups(P=0.020)and the disease-free survival time of the two groups(P=0.013)was statistically significant(all P<0.05).Adverse reactions:the incidence rate of neutropenia,nausea and vomiting,diarrhea,liver dysfunction and fatigue in the observation group was lower than that in the control group,but the anemia was higher than that in the control group,mostly of grade?-?,and the difference among neutropenia,anemia and nausea and vomiting was statistically significant(all P<0.05).Univariate and multifactor COX analysis showed that differentiation degree(P=0.044)and treatment plan(P=0.018)were independent influencing factors of overall survival.ConclusionsThe long-term efficacy of paclitaxel liposome combined with cisplatin in the treatment of advanced esophageal squamous cell carcinoma is better than that of 5-fluorouracil combined with cisplatin,with fewer adverse reactions,safety and controllability,which can bring benefits to patients.