Randomized Controlled Study On TP And FP Chemotherapies For Advanced Esophageal Cancer And Study On Correlation Between ERCC1 Expression And Sensitivity Of Cisplatin-based Chemotherapy

Objective: To observe the curative effects and adverse reactions of Taxol plus cisplatin(TP scheme) and 5-fluorouracil plus cisplatin(FP scheme) for the treatment of advanced esophageal cancer;and to investigate the relationship between ERCC1 expression in advanced esophageal cancer and the chemotherapy effect treated with cisplatin.Method: This experiment was divided into two parts according to the research objectives:1.A randomized trial of TP and FP chemotherapies for advanced esophageal carcinoma.1.1 The 98 patients with pathologically-diagnosed advanced esophageal cancer were randomly divided into two groups: the experimental group(n=50) was given TP chemotherapy;while the control group(n=48) was given FP chemotherapy.The chemotherapy was repeated once every 3 weeks, and the curative effects were evaluated after 2 continuous cycles.1.2 SPSS16.0 was used for statistical analysis.2. Study on the correlation between the ERCC1 expression and chemotherapysensitivity of advanced esophageal cancer to cisplatin-based schemes.2.1 The 98 pathological specimens of advanced esophageal cancer patients were collected to detect ERCC1 expression.All patients received cisplatin chemotherapy.The researchers observe the effect of patients receiving cisp;atin-containing combination chemotherapy programs,and analyze the relationships between ERCC1 expression and objective response rate、disease control rate、progression-free survival、overall survival.2.2 SPSS16.0 was used for statistical analysis.Results: 1. Total effective rates of TP and FP group were 68.0% and 41.6% respectively, and the difference was statistically significant(X2=6.864, P =0.009). Common adverse reactions of the two groups were mainly bone marrow suppression and gastrointestinal reaction, and there was no statistically significant difference(P > 0.05). TP group appeared tolerable pain in the muscles and joints, which will not affect the chemotherapy.2. In all 98 patients,the positive rate of ERCC 1 expression was 56.1%(55/98),the overall disease control rate was 70.4%(69/98),while objective response rate in negative group of ERCC 1 expression(76.7%) was higher than that in positive group(38.2%),which showed statistical difference( Χ2=14.506,P =0.000);disease control rate in negative group of ERCC 1 expression(88.4%) was higher than that in positive group(56.4%),which showed statistical difference(Χ2=11.867,P=0.001); The expression of ERCC1 two groups progression-free survival and overall survival difference between positive and negative have similar changes(P>0.05).Conclusion:1. TP scheme has certain curative effects for treatment of advanced esophageal cancer, and its toxicity can be tolerated.2. There is a correlation between ERCC1 gene expression in pathological tissues of advanced esophageal cancer and short-term curative effects of cisplatin-based combination chemotherapy.