Efficacy Analysis of Concurrent Chemoradiotherapy with TP and FP Regimens for Esophageal Squamous Cell Carcinoma Based on Propensity Score Matching
Year: 2025
Type: article
Study design: Observational Study
Abstract: Objective: To evaluate the efficacy and toxicity of concurrent chemoradiotherapy with paclitaxel/cisplatinum versus 5-fluorouracil/ cisplatinum in patients with esophageal squamous cell carcinoma. Methods:The medical records of 348 patients with esophageal squamous cell carcinoma who received concurrent chemoradiotherapy in the Fourth Hospital of Hebei Medical University from January 1, 2005 to December 31, 2015 were retrospectively analyzed.Of the patients enrolled, 295 received 5-fluorouracil/cisplatinum regimen (FP group) and 53 received paclitaxel/cisplatinum regimen (TP group).Survival analysis was performed and PSM (Propensity Score Matching) was conducted to evaluate and compare the local control, overall survival and adverse reactions between TP and FP groups.Results: A total of 98 patients with good balance in observed co-variables were enrolled.There was no significant difference in clinical data between the two groups after PSM (P > 0.05).After matching, the local control rate and overall survival rate of TP group were significantly better than those of FP group.The 1-year, 3-year, 5-year local control rates were 76.6%, 69.9%, 66.4% for patients in the TP group, respectively, and 71.7%, 36.6%,27.4% for patients in the FP group, respectively (χ 2 = 6.123,P = 0.012).The 1-year, 3-year, 5-year overall survival rates were 79.6%, 53.1%, 42.5% for patients in the TP group, respectively, and 65.3%, 20.4%, 12.2% for patients in the FP group, respectively (χ 2 = 12.246, P = 0.000).The median survival time in the TP group was 41 months, significantly longer than 19 months in the FP group.In contrast, there was a trend towards increased acute radiation esophagitis toxicity among patients in TP group (77.56% vs 55.11%), mainly grade 2 esophagitis, no grade 3 esophagitis occurred, while 3 patients in the FP group had grade 3 acute radiation esophagitis.None experienced grade 5 and grade 4 acute oesophagitis.The TP group has a higher incidence of upper gastrointestinal toxicities, leukopenia and thrombocytopenia than FP group (71.43% vs 38.78%, 81.63% vs 71.43%, 28.57% vs 8.16%, respectively, P＜0.05).Similar rates of acute radiation pneumonitis, lower gastrointestinal toxicities, and hemoglobin reduction were observed between patients in TP group versus FP group.Multivariate analysis of Cox regression model showed that different chemotherapy regimens and TNM stage were independent prognostic factors.Compared with the FP regimen, the TP regimen was a survival benefit factor (HR = 0.486, P = 0.002).Late clinical TNM stage is a prognostic risk factor for esophageal cancer (HR = 1.648,P = 0.008). Conclusions:Patients with unresectable esophageal squamous cell carcinoma have obvious survival benefits from TP regimen during concurrent chemoradiotherapy, and the adverse reactions are tolerable, so TP regimen can be used as the optimal chemotherapy regimen during radiotherapy.
Source: Acta Scientific Medical Sciences
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
Funder: Hebei Medical University
OpenAlex ID: W4414153550