Clinical Observation Of Albumin-bound Paclitaxel Combined With Cisplatin In The First-line Treatment Of Advanced Esophageal Squamous Cell Carcinoma

ObjectiveThis study aimed to explore the effectiveness and safety of the albumin-bound paclitaxel combined with cisplatin regimen in the first-line treatment of advanced esophageal squamous cell carcinoma.MethodsThis study included 25 patients with advanced esophageal squamous cell carcinoma who received albumin-bound paclitaxel combined with cisplatin(nab-TP group)regimen from September 2018 to August 2020 in the Affiliated Hospital of Qinghai University,25 patients with advanced esophageal squamous cell carcinoma undergone solvent-based paclitaxel combined with cisplatin(sb-TP group)regimen.The study group received nab-TP regimen:albumin-bound paclitaxel 260mg/m~2,intravenous infusion for at least 30 minutes,d1;cisplatin 75mg/m~2,intravenous infusion for 2 hours,1-3 days of administration,every 21 days is a cycle.The control group received sb-TP regimen:solvent-based paclitaxel 175mg/m~2,intravenous infusion for 3 hours,d1;cisplatin 75mg/m~2,intravenous infusion for 2 hours,1-3 days of administration,every 21 days is a cycle.The sb-TP group was pretreated with conventional anti-allergic drugs before treatment.Each patient completed at least 2cycles of chemotherapy and the therapy was continued until the disease progression or unacceptable toxicity.Efficacy evaluation was performed after every 2 cycles of treatment,and adverse reactions were evaluated every cycle,and the objective response rate(ORR),disease control rate(DCR),progression-free survival(PFS)and various treatment-related adverse reactions of the two groups were compared to determine whether there was a difference in overall incidence.Results1.Efficacy observation:The objective response rate(ORR)of the nab-TP group was 56.0%,the disease control rate(DCR)was 88.0%,and the median progression-free survival(m PFS)was 7.0 months(95%confidence interval was 5.8-8.2 months);the ORR of patients in the sb-TP group was 44.0%,DCR was 76.0%,and m PFS was5.6 months(95%confidence interval was 5.0-6.2 months).There is no statistical significance in both ORR and DCR differences(P>0.05),but the difference in PFS between the two groups was statistically significant(P=0.039).The nab-TP regimen has more advantages in prolonging the progression-free survival of patients with advanced esophageal squamous cell carcinoma.2.Adverse reactions:The grade 3 and grade 4 treatment-related adverse reactions caused by the nab-TP group mainly included 5 cases of neutropenia(20.0%),4 cases of leukopenia(16.0%),and 1 case of febrile neutropenia(4.0%),thrombocytopenia in 1 case(4.0%),nausea/vomiting in 1 case(4.0%).Other adverse reactions include peripheral sensory neurotoxicity,joint pain,fatigue and increased bilirubin,all of which are mainly grade 1-2.In general,except for leukopenia,nausea/vomiting and fatigue,the nab-TP group had a lower incidence of various adverse reactions than the sb-TP group,and there was no statistically significant difference in the incidence of various adverse reactions between the two groups(P>0.05).ConclusionThe first-line treatment of advanced esophageal squamous cell carcinoma based on albumin-bound paclitaxel combined with cisplatin shows good efficacy,and the adverse reactions are tolerable,the safety is better,and the clinical application prospects are broad.