Comparing The Efficacy And Toxicity Of Concurrent Radiotherapy With Taxane Combined With Platinum And Fluorouracil Combined With Cisplatin In The Treatment Of Unresectable Esophageal Cancer-Meta Analysis

Objective: To systematically review the paclitaxel/Docetaxel combined with Platinum(PTX)regimen and Fluorouracil combined with Cisplatin(PF)regimen in the simultaneous treatment of esophageal cancer with radiotherapy The efficacy and toxicity of the drug.Methods:The PubMed,CNKI database and Google Scholar were searched by computer,and the quality evaluation and data extraction of the studies that met the inclusion criteria were carried out independently,and the data was meta-analyzed with Stata 11.1 software.Results: A total of 10 studies were included after screening,4 were cohort studies,and 6 were randomized controlled studies.A total of 1098 cases were enrolled,including 1047 cases(95.4%)of squamous cell carcinoma and 51 cases(4.6%)of adenocarcinoma.There were 560 cases(51.0%)in the PTX group and 538 cases(49.0%)in the PF group.The toxic reactions included in the analysis included hematological toxicity(myelosuppression of white blood cells,platelets,and hemoglobin),gastrointestinal reactions(nausea,vomiting,diarrhea),acute radiation pneumonia,and acute radiation esophagitis.The two groups were compared with grade 3 and above.There were no statistically significant differences in hematological toxicity,gastrointestinal reactions,and radiation pneumonitis[RR=1.22,95%CI(0.80,1.86),P=0.353;RR=0.94,95%CI(0.65,1.35),P=0.741;RR=0.70,95%CI(0.35,1.41),P=0.321].Radiation esophagitis was more severe in the PF regimen [RR=0.63,95%CI(0.47,0.85),P=0.002].In terms of short-term efficacy,the complete remission rate of the PTX group was higher than that of the PF group [RR=1.43,95%CI(1.04,1.97),P=0.029].The comparison of the two groups was not statistically significant [RR=1.05,95%CI(0.88,1.25),P=0.599;RR=1.14,95%CI(1.00,1.30),P=0.057;RR=1.03,95%CI(0.99,1.08),P= 0.164].In terms of overall survival rate,the1-year,2-year,and 3-year survival rates of the PTX group were higher than those of the PF group,and the statistical difference was significant [RR=1.06,95%CI(1.00,1.13),P=0.048;RR=1.06,95 %CI(1.00,1.13),P=0.029;RR=1.26,95%CI(1.10,1.48),P=0.001,there was no significant difference in the 5-year survival rate between the two schemes RR=1.50,95%CI(0.96,2.35),P=0.076].The 1-year,2-year,and 3-year disease progression-free survival rate of the PTX group was higher than that of the PF group [RR=1.13,95%CI(1.02,1.25),P=0.023;RR=1.50,95%CI(1.25,1.79),P<0.001;RR=1.33,95%CI(1.06,1.67),P=0.014].Conclusion:Compared with the PF regimen,the PTX regimen is synchronized with radiotherapy to treat locally advanced esophageal cancer.It has a trend of benefit in terms of clinical complete remission rate,overall survival rate and disease progression-free survival rate.The two regimens treat related hematological toxicity,gastrointestinal There is no difference in tract response and acute radiation pneumonia.PTX has lower esophageal toxicity and may be the preferred concurrent chemotherapy for esophageal squamous cell carcinoma.The conclusions of the study still need to be further confirmed by prospective trials.