Analysis Of Albumin-bound Paclitaxel Combined With Nedaplatin Two Cycles Of Preoperative Neoadjuvant Chemotherapy On Operation And Prognosis Of Patients With Locally Advanced Esophageal Cancer

Objective:To study the clinical effect of the two-cycle preoperative neoadjuvant chemotherapy regimen of albumin-bound paclitaxel combined with nedaplatin in patients with locally advanced esophageal cancer,and to provide certain theoretical reference for preoperative neoadjuvant chemotherapy in patients with locally advanced esophageal cancer.Methods:Patients with locally advanced esophageal cancer who met the inclusion and exclusion criteria of this study from January 2019 to December 2020 in our hospital were collected as clinical data for retrospective analysis.According to different treatment regiments,21 patients who received radical esophageal cancer after two cycles of preoperative neoadjuvant chemotherapy with albumin-bound paclitaxel combined with nedaplatin were selected as the observation group,and 30patients who received radical esophageal cancer resection alone were selected as the control group.The preoperative neoadjuvant chemotherapy regimens in the observation group were:albumin-bound paclitaxel 270mg/m~2 intravenous infusion on the 1st and 8th days+nedaplatin 100mg/m~2 intravenous infusion on the 1st day,repeated every 3 weeks.Chemotherapy efficacy was evaluated according to the efficacy standard of the International Union Against Cancer.The tumor downstaging criteria refer to the 8th edition of the TNM staging criteria for esophageal cancer(AJCC 2017).Adverse reactions during preoperative neoadjuvant chemotherapy were evaluated and graded according to the CTCAE 5.0 version of the common adverse reaction evaluation criteria.Statistical analysis was used to compare the differences between the observation group and the control group in terms of intraoperative bleeding,operative time,complete resection rate,postoperative complication rate,length of hospital stay,postoperative distant metastasis rate,and survival rate.After collecting and sorting out,the final conclusion is drawn.Results:After receiving preoperative neoadjuvant chemotherapy in the observation group,13 patients achieved partial remission after relevant imaging examinations,8 patients had stable disease,and the objective response rate was61.9%;Tumor downstaging in 9 patients after preoperative neoadjuvant chemotherapy,the tumor downstaging rate was 42.86%;the incidence of adverse reactions during the overall chemotherapy was low.There was no significant difference in intraoperative bleeding,postoperative long-term survival rate,postoperative anastomotic bleeding and the incidence of mediastinal infection between the observation group and the control group(P>0.05).There were significant differences between the observation group and the control group in the days of hospitalization,operation time,the incidence of postoperative distant metastasis,the incidence of postoperative anastomotic leakage and pulmonary infection(P<0.05).Conclusion:For locally advanced esophageal cancer patients with surgical indications,preoperative neoadjuvant chemotherapy with two cycles of albumin-bound paclitaxel combined with nedaplatin can effectively reduce the incidence of postoperative anastomotic fistula and pulmonary infection,and reduce the length of hospitalization,and the incidence of postoperative distant metastasis,and the vast majority of patients showed a high objective response rate and tumor downstaging rate after chemotherapy,and the incidence of adverse reactions during chemotherapy was low.The clinical effect of two-cycle preoperative neoadjuvant chemotherapy regimen of albumin-bound paclitaxel combined with nedaplatin in the treatment of locally advanced esophageal cancer is worthy of recognition.