S-1 同步放化疗对比多西他赛和顺铂同步放化疗治疗局部晚期食管鳞癌
Concurrent chemoradiotherapy with S-1 compared with concurrent chemoradiotherapy with docetaxel and cisplatin for locally advanced esophageal squamous cell carcinoma.
机构信息
Department of Radiation Oncology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China.
出版信息
Radiat Oncol. 2021 May 26;16(1):94. doi: 10.1186/s13014-021-01821-6.
BACKGROUND
This retrospective study was to assess and compare the toxicity and efficacy of concurrent chemoradiotherapy (CCRT) with S-1 or docetaxel and cisplatin in patients with locally advanced esophageal squamous cell carcinoma (ESCC).
METHODS
Patients with locally advanced ESCC who received CCRT with S-1 (70 mg/m twice daily on days 1-14, every 3 weeks for 2 cycles, S-1 group) or docetaxel (25 mg/m) and cisplatin (25 mg/m) on day 1 weekly (DP group) between 2014 and 2016 were retrospectively analyzed. Radiotherapy was delivered in 1.8-2.0 Gy per fraction to a total dose of 50-60 Gy. Treatment-related toxicities (Common Terminology Criteria for Adverse Events version 4.0), response rate, and survival outcomes were compared between groups.
RESULTS
A total of 175 patients were included in this study (72 in the S-1 group and 103 in the DP group). Baseline characteristics were well balanced between the two groups. The incidence of grade 3-4 adverse events were significantly lower in the S-1 group than that of the DP group (22.2% vs. 45.6%, p = 0.002). In the DP group, elderly patients (> 60 years) had a significantly higher rate of grade 3-4 adverse events than younger patients (58.1% vs. 31.3%, p = 0.01). The objective overall response rate (complete response + partial response) was 68.1% in the S-1 group, and 73.8% the DP group (p = 0.497). The 3-year overall survival was 34.7% in the S-1 group, and 38.8% in the DP group (p = 0.422). The 3-year progression free survival in the DP group was higher than that in the S-1 group but without significant difference (33.0% vs. 25.0%, p = 0.275).
CONCLUSION
CCRT with S-1 is not inferior to CCRT with docetaxel and cisplatin and is better tolerated in in elderly patients with locally advanced ESCC.
背景
本回顾性研究旨在评估和比较局部晚期食管鳞状细胞癌（ESCC）患者同步放化疗（CCRT）中替吉奥（S-1）或多西他赛联合顺铂的毒性和疗效。
方法
2014 年至 2016 年期间，对接受 S-1（70mg/m，每日 2 次，第 1-14 天，每 3 周 2 个周期，S-1 组）或多西他赛（25mg/m）联合顺铂（25mg/m）每周 1 天（DP 组）的局部晚期 ESCC 患者进行 CCRT 治疗，采用 1.8-2.0Gy/次，总剂量 50-60Gy。比较两组间治疗相关毒性（不良事件通用术语标准 4.0 版）、缓解率和生存结局。
结果
本研究共纳入 175 例患者（S-1 组 72 例，DP 组 103 例）。两组患者的基线特征均衡。S-1 组 3-4 级不良事件发生率明显低于 DP 组（22.2% vs. 45.6%，p=0.002）。DP 组中，老年（>60 岁）患者的 3-4 级不良事件发生率明显高于年轻患者（58.1% vs. 31.3%，p=0.01）。S-1 组的客观总缓解率（完全缓解+部分缓解）为 68.1%，DP 组为 73.8%（p=0.497）。S-1 组的 3 年总生存率为 34.7%，DP 组为 38.8%（p=0.422）。DP 组的 3 年无进展生存率高于 S-1 组，但差异无统计学意义（33.0% vs. 25.0%，p=0.275）。
结论
CCRT 中替吉奥（S-1）并不逊于多西他赛联合顺铂，且在局部晚期 ESCC 老年患者中耐受性更好。
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