A Comparing Trial Of The Efficacy Of Different Chemotherapy Regimens And Prognosis Factor Analysis In Treatment Of Patients With Advanced Esophageal Squamous Cell Carcinoma

Objective:The study aims at analysis of the clinically relevant information of 118 patients with advanced esophageal squamous cell carcinoma,who were received gemcitabine or paclitaxel plus platinum-based chemotherapy in our hospital, investigate the efficacy of different chemotherapy regimens and the factors that affect the prognosis of advanced esophageal squamous cell carcinoma.Methods:We collect the clinically relevant information of 118 patients with advanced esophageal squamous cell carcinoma, who were diagnosised by pathological and were newly treatmented in our hospital, from January 2006 to March 2016. 51 patients received gemcitabine plus platinum,67 patients received paclitaxel plus platinum.We use two independent samples nonparametric test to compare the short-term efficacy of chemotherapy;chi-square test compare the side effects of chemotherapy;survival rate analysis were performed by life-table method;long-term efficacy and prognostic factors analysis using Kaplan-Meier method;using COX proportional hazards modelthe to analyze the meaningful factors for multivariate analysis and looking for the independent prognostic factor.Results:1、118 patients were enrolled.The total number of treatment cycles administered was 470 in these patients.The median overall survival was 10.8 months.The survival rate of one year(32.2%) and two year(16.9%).There are 205 treatment cycles in the team of gemcitabine.The CR was 5(9.8%),with 20(39.3%) PR and 25(49.0%)RR.There are 265 cycles of chemotherapy in the team of paclitaxel.The RR was30(44.8.0%),with 6(8.9%) CR and 24(35.8%) PR. P>0.05,it is mean that short-term efficacy between the two groups is no significant difference.The median overall survival was 11 months in gemcitabine group,one year survial rate(33.3%)and two year survial rate(15.6%).The median overall survival was 10.4 months in paclitaxel group,one year survial rate(31.3%)and two year survial rate(17.9%). P>0.05, It ismean that there is no significant difference between the two groups of long-term efficacy.The hematologic toxicity encountered in patients treated with gemcitabine-based regimen was grade 3/4 neutropenia(27.4%) and thrombocytopenia(25.4%),the other group was 10.4% and 7.4%.P<0.05.The rate of the hematologic toxicity with gemcitabine-based regimen is higher than with paclitaxel-based regimen.Grade 3/4 gastrointestinal adverse were experienced by patients receiving gemcitabine-based regimen and the paclitaxel-based regimen was 19.6% and16.4%.P>0.05. Grade 3 alopecia 3(4.5%) with paclitaxel,the other group doesn’t happen.The adverse effects of the two groups are moderate。2、Univariate analysis:Age,anemia or not,metastasis degree,treatment modalities,chemotherapy cycles and time to progression are the prognostic factors of survival of advanced esophageal squamous cell carcinoma.3、COX proportional hazards model for multivariate analysis imply that anemia or not,metastasis degree and time to progression are are independent prognostic factor in advanced esophageal squamous cell carcinoma.Conclusion:1、There is no significant difference about the short-term and long-term efficacy between the two groups which receiving gemcitabine-based regimen and the paclitaxel-based regimen. Grade 3/ 4 neutropenia and thrombocytopenia,the rate of gemcitabine-based regimen is higher than paclitaxel-based regimen.Grade 3alopecia is easily heppened with paclitaxel.The adverse effects of the two chemotherapy regimens are moderate, They can be used as options for advanced esophageal squamous cell carcinoma chemotherapy.2、Age,anemia or not,metastasis degree,treatment modalities,chemotherapy cycles and time to progression are the prognostic factors of survival of advanced esophageal squamous cell carcinoma.3、Anemia or not,metastasis degree and time to progression are independent prognostic factor in advanced esophageal squamous cell carcinoma.