Research On The Clinical Outcome Of Advanced Esophageal Cancer Treated With Paclitaxel Influenced By β-tubulin Gene Polymorphism In Peripheral Blood

Esophageal cancer is one of the common malignant tumors in our country, and thechemotherapy of Cisplatin plus5-fluorouracil has increased the response rate ofadvanced esophageal cancer, however limited by the unavoidable adverse reactions.Paclitaxel showed a good curative effect in treatment with advanced esophageal cancer.The first part of this paper retrospectively compared the curative effect of taxol andother regimens, and the second part studies the influence of curative effect by β-tubulingene mutations in esophagus.Part One: Comparative study of paclitaxel plus nedaplatincomparing with nedaplatin plus5-fluorouracil combinationchemotherapy as the first line combination chemotherapy inpatients with advanced esophageal cancerObjective This study was performed to evaluate and compare the chemotherapies ofpaclitaxel plus nedaplatin and nedaplatin plus5-fluorouracil as the first line in patientswith advanced esophageal squamous cell carcinoma.Methods We studied a total of42patients, which were treated with paclitaxel plusnedaplatin combination chemotherapy or nedaplatin plus5-fluorouracil.Evaluate theresponse and survival.Results The difference had statistical significance. And the most severe adverse eventwas neutropenia and vomit. Conclusions Combination of paclitaxel plus nedaplatin was an more active regimenwith excellent tolerability than nedaplatin plus5-fluorouracil combinationchemotherapy as a first-line treatment of advanced esophageal cancer. Part Two: Research on the correlation between the mutation ofβ-tubulin gene and the efficacy of paclitaxel-based chemotherapytreated with advanced esophageal cancerObjective To predict the chemoresistance to paclitaxel in advanced esophagealcancer,we examined the genetic mutations of the beta-tubulin gene in peripheral blood.Methods Forty-six patients of advanced esophageal cancer were enrolled, all of whichwere treated with paclitaxel combining with fluorouracil or cisplatin chemotherapies.The tumor responses and PFS were assessed. The polymorphisms were detected afterDNA PCR amplifications，which extracted from peripheral blood karyocyte before thefirst chemotherapies. Statistical analysis was performed using SPSS statistical softwarepackage13.0with P≤0.05considered as statistically signficant. Chi-square test andLog-rank analysis was used for the analysis of remission rate and the mutations.Results The results showed that the difference of patients with or without beta-tubulinmutations in exons4had statistical significance.Conclusions These mutations may represent a novel mechanism of resistance andshould be examined prospectively for paclitaxel-based chemotherapy in the future.