ABSTRACT
Objective:To compare the prognosis of fluoroucil combined with cisplatin and paclitaxel combined with cisplatin regimens with concurrent radiotherapy in treatment of esophageal squamous cell carcinoma.Methods:A total of 120 patients with esophageal squamous cell carcinoma who were admitted to Anyang Tumor Hospital of Henan Province from December 2012 to November 2018 were randomly divided into group A and group B by using a random number generator. Group A was given cisplatin combined with 5-fluorouracil, and group B was given cisplatin combined with paclitaxel. Both groups had the same radiotherapy regimen, and both used intensity-modulated radiation therapy (IMRT). Completions of 50 Gy radiotherapy and at least one cycle of chemotherapy were considered to be in line with the plan. Survival data was analyzed in the term of intention-to-treat (ITT) and per-protocol (PP) set.Results:Of the 120 patients, 114 patients were treated and the adverse reactions could be evaluated, including 55 cases in group A and 59 cases in group B. The incidence of grade Ⅲ-Ⅳ leukopenia in group B was higher than that in group A [49.2% (29/59) vs. 25.5% (14/55)], and the difference was statistically significant ( χ2 = 6.805, P = 0.012), and there were no statistical differences in the other adverse reactions between the two groups (All P > 0.05). A total of 113 cases can be analyzed for survival. According to ITT analysis, the median progression-free survival (PFS) time in group A and group B was 28.0 months (95% CI 15.5-34.5 months) and 27.0 months (95% CI 17.0-41.0 months), the median overall survival (OS) time was 28.0 months (95% CI 15.8-34.2 months) and not reached, the differences were not statistically significant (both P > 0.05). According to PP analysis, the median PFS time in group A and group B was 28.0 months (95% CI 15.8-34.2 months) and 29.0 months (95% CI 14.9-45.1 months), the median OS time in group A and group B was 28.0 months (95% CI 3.7-52.3 months) and not reached, the differences were not statistically significant (both P > 0.05). Conclusions:The fluorouracil combined with cisplatin regimen and paclitaxel combined with cisplatin regimen with concurrent radiotherapy have similar PFS and OS time in treatment of esophageal squamous cell carcinoma, the adverse reactions are different, but they are all tolerable. In individualized clinical practice, the toxicities and costs of the two regimens can be comprehensively considered.
ABSTRACT
Purpose To characterize the alterations and significance of Rb in concurrent esophageal and gastric cardia precancerous lesions (dysplasia) from the same patients in Henan,a high-incidence area of esophageal carcinoma.Methods Rb protein expression was detected by the immunohistochemical staining (ABC method) in 30 patients with both esophageal and gastric cardia dysplasia in Henan area.Results Rb positive rates in esophageal epithelial dysplasia (EDYS) and gastric cardia dysplasia (GDYS) were 70% (21/30) and 80% (24/30), respectively, and the difference was not significant,(χ~2=0.800,P>0.05).However, there were 25 patients with Rb coincident changes in EDYS and GDYS from the same patient in 30 cases of esophageal and gastric cardia dysplasia (83%,25/30). The positive coincidence rate for Rb positive expression in EDYS and GDYS from the same patient accounted for 67% (20/30) and the negative coincidence rate was 17% (5/30) (Kappa=0.561,P<0.01).The significant relationship between Rb coincidence expression in EDYS and GDYS was found (P<0.01).Conclusions The high coincident alterations of Rb in EDYS and GDYS from the same patient indicate the possibility of similar molecular basis, which provides an important etiological clue for the similar geographic distribution and risk factors involved in esophageal squmaous cell carcinoma and gastric cardia adenocarcinoma.