ABSTRACT
Objective:To explore the clinical characteristics and prognosis of metastatic sites symptom as the first manifestation in esophageal carcinoma patients with stage T 1 and T 2, and to provide a reference for clinical practice. Methods:The clinical data of 50 esophageal carcinoma patients with stage T 1 and T 2 who had lymph node or distant metastasis as the first symptom in Anyang Tumor Hospital of Henan Province from November 2007 to December 2019 were retrospectively analyzed. Survival analysis was performed by using Kaplan-Meier method. Univariate analysis was performed by using log-rank test. Results:Among 50 patients with esophageal carcinoma, lymph node metastases as the first symptom were found in 42 cases and distant organ metastases as the first symptom were found in 8 cases. The 1-, 3-, 5-year overall survival rates of patients with stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ were 58.7%, 49.0%, 16.3% and 56.1%, 12.2%, 0, respectively, and there was no statistically significant difference in OS of both groups ( P = 0.094). The 1-, 3-, 5-year overall survival rates of patients with stage N 1 and stage N 2-N 3 were 63.5%, 34.7%, 17.3% and 52.2%, 11.9%, 0, respectively, and there was no statistically significant difference in OS of both groups ( P = 0.083). The 1-, 3-, 5-year overall survival rates were 64.6%, 30.5%, 18.3%, respectively in radiotherapy group and 38.2%, 0, 0, respectively in non-radiotherapy group, and there was a statistically significant difference in OS of both groups ( P = 0.008); the progression-free survival in radiotherapy group was better than that in non-radiotherapy group ( P = 0.028). The 1-, 3-, 5-year overall survival rates were 70.8%, 35.5%, 21.3% and 33.3%, 0, 0 and 35.4%, 0, 0, respectively in concurrent chemoradiotherapy group, radiotherapy group and chemotherapy group, and there was a statistically significant difference in overall survival among three groups ( P = 0.004). The results of univariate analysis showed that radiotherapy ( χ2 = 7.112, P = 0.008) and concurrent chemoradiotherapy ( χ2 = 10.940, P = 0.004) were the main factors affecting the prognosis. Conclusions:Lymph node and distant metastasis could occur in esophageal carcinoma patients with stage T 1 and T 2. Radiotherapy can prolong the progression-free survival time and concurrent chemoradiotherapy could benefit overall survival of these patients.
ABSTRACT
Objective To compare and analyze the effect of single PT (taxol,cisplatin) chemotherapy and the PT chemotherapy combined with Aidi injection in the medium and advanced esophageal patients,in order to maximize the strength chemotherapy' s effects,reduce the side effects,improve the patients' life qualities.Methods 106 cases of esophageal patients were randomly divided into two groups,53 patients for each group.The control group were treated by the single PT chemotherapy protocol,while the treatment group were combined with Aidi and PT chemotherapy protocol,21 days time peroid was taken as one circle.After two weeks,the effect,the patients' life qualities and the side effects between two groups were compared.Results The effective rates of treatment group and control group were 90.37 ％ (48/53) and 81.13 ％ (43/53),respectively,there was no statistic significance (P ＞ 0.05).The median-survival in two groups were 48 weeks and 42 weeks,which was statistic significance (P =0.027).The treatment group' s side effects incidence rate was lower than that of control group in Ⅲ-Ⅳ degree gastrointestinal reaction (Ⅲ degree P =0.026,Ⅳ degree P =0.027),Ⅲ-Ⅳ degree of inhibition of white blood cells (Ⅲ degree P =0.038,Ⅳ degree P =0.040),Ⅲ degree platelet inhibition (P =0.023) and Ⅱ-Ⅲ degree hypohemia (Ⅱ degree P =0.020,Ⅲ degree P =0.041).There were no statistically differences between treatment group and control group in liver,muscle,kidney toxicity and baldness (P ＞ 0.05).There were significant differences in Karnofsky score and body mass between pre-and post-treatment in chemotherapy group (P =0.067),but those in treatment group were not (P =0.006).Conclusion The Aidi injection combined with PT chemotherapy protocol has a better effect in the esophageal cancer patients,longer median survival time,reduced the side effects and improved the patients' life qualities,which is deserved to be used in the clinical furtherly.