Background & objective: The prognosis of advanced esophageal cancer is poor. There are no definite prognostic factors and standard regimens for these patients. This study was to analyze the responses of advanced esophageal cancer to chemotherapy, and explore its probable prognostic factors.
Methods: Clinical data of 138 naïve patients with histologically or pathologically confirmed advanced esophageal cancer, treated from Dec. 1984 to Apr. 2006 in Cancer Hospital of Chinese Academy of Medical Sciences, were analyzed using Chi-square test, Kaplan-Meier method, and log-rank test. Of the 138 patients, 68 were treated with taxol or gemcitabine or oxaliplatin (new drug group), including 64 (94.1%) treated with cisplatin; 70 were treated without taxol, gemcitabine and oxaliplatin (conventional drug group), including 48(68.6%) treated with cisplatin.
Results: The response rate of 138 patients was 47.8%. The median time to progression (TTP) was 4 months; the median survival time was 10 months. The response rate was significantly higher in new drug group than in conventional drug group (58.8% vs. 37.1%, P=0.011). Univariate analysis indicated that age, hemoglobin (HB) level before treatment, chemotherapy cycles, short-tem efficacy, TTP and therapeutic methods were significant prognostic factors. Cox multivariate regression analysis showed that TTP, therapeutic methods and HB level before treatment were independent prognostic factors.
Conclusions: Taxol or gemcitabine combined cisplatin has certain effect on advanced esophageal cancer. TTP, therapeutic methods and HB level before treatment are independent prognostic factors of this disease.