Efficacy and safety of concurrent chemoradiotherapy with paclitaxel-based or S-1 regimens in treating elderly patients with esophageal squamous cell carcinoma: A multi-center propensity-score matched study
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引用次数: 0
Abstract
Background
Elderly patients with esophageal cancer can benefit from concurrent chemoradiotherapy (CCRT). However, the optimal concurrent chemotherapy regimen remains undetermined. We aimed to compare the efficacy and safety of CCRT with paclitaxel-based or S-1 regimens in treating elderly patients with esophageal squamous cell carcinoma (ESCC).
Methods
From January 2016 to November 2022, a total of 349 patients aged 70 and above with ESCC were included. The patient population was divided into two treatment groups: patients receiving paclitaxel-based CCRT were allocated to the TP group, and those receiving S-1 regimen CCRT were allocated to the S-1 group. Propensity score matching (PSM) was used to balance potential biases. Survival outcomes, overall response rate, and treatment-related toxicities were assessed.
Results
After PSM, there were 82 patients in each group. The median follow up of the surviving patients was 42.6 months (IQR 28.0–58.8 months). The 2-year overall survival (OS) rate (71.4% vs 65.4%; log-rank P = 0.010) and progression-free survival (PFS) rate (64.4% vs 58.0%; log-rank P = 0.048) were significantly higher in the TP group. Compared with the S-1 group, the TP group experienced a higher rate of grade 3 and above hematologic toxicities, such as leukopenia (47.6% vs 15.9%, P < 0.001) and neutropenia (35.4% vs 6.1%, P < 0.001). One patient in the TP group and two patients in the S-1 group had grade 5 toxic effects.
Conclusions
Our findings suggest that paclitaxel-based CCRT was well tolerated in elderly patients with ESCC and provided significant survival benefits over S-1 regimen.
背景老年食管癌患者可从同期化放疗（CCRT）中获益。然而，最佳的同期化疗方案仍未确定。我们旨在比较CCRT与基于紫杉醇或S-1方案治疗老年食管鳞状细胞癌（ESCC）患者的疗效和安全性。方法从2016年1月至2022年11月，共纳入349例70岁及以上的ESCC患者。患者分为两个治疗组：接受紫杉醇为基础的CCRT的患者被分配到TP组，接受S-1方案CCRT的患者被分配到S-1组。采用倾向评分匹配法（PSM）来平衡潜在的偏倚。对生存结果、总体反应率和治疗相关毒性反应进行了评估。存活患者的中位随访时间为 42.6 个月（IQR 28.0-58.8 个月）。TP组的2年总生存率（71.4% vs 65.4%；log-rank P = 0.010）和无进展生存率（64.4% vs 58.0%；log-rank P = 0.048）明显高于S-1组。与 S-1 组相比，TP 组出现 3 级及以上血液学毒性的比例更高，如白细胞减少症（47.6% vs 15.9%，P < 0.001）和中性粒细胞减少症（35.4% vs 6.1%，P < 0.001）。结论我们的研究结果表明，以紫杉醇为基础的CCRT在老年ESCC患者中耐受性良好，与S-1方案相比生存率显著提高。
期刊介绍：
Translational Oncology publishes the results of novel research investigations which bridge the laboratory and clinical settings including risk assessment, cellular and molecular characterization, prevention, detection, diagnosis and treatment of human cancers with the overall goal of improving the clinical care of oncology patients. Translational Oncology will publish laboratory studies of novel therapeutic interventions as well as clinical trials which evaluate new treatment paradigms for cancer. Peer reviewed manuscript types include Original Reports, Reviews and Editorials.
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