[Efficacy of platinum analogue-based chemotherapy for advanced esophageal squamous cell carcinoma and prognostic factors].

Objective: To analyze the outcome of platinum analogue-based chemotherapy for advanced esophageal squamous cell carcinoma (ESCC) patients treated in Cancer Hospital of Chinese Academy of Medical Science. The association of response rate or OS and the clinical-pathological factors were analyzed as well.

Methods: Clinical data of 134 advanced ESCC were retrospectively analyzed from January 1999 to August 2008 in our hospital. All of these chemo-naive patients received platinum analogue-based chemotherapy. The association of response rate or OS and the clinical-pathological factors were analyzed.

Results: The median age of all the 134 patients was 58 years old. The ratio of male and female was 7.9:1. A total of 450 cycles (median: 3 cycles) of chemotherapy was completed. 91 (67.9%) of these patients received cisplatin-based regimens. The overall response rate was 31.3%, and cisplatin-based regimens were better than other platinum analogue-based regimen, but there was no significant difference (36.3% vs 20.9%, P = 0.075). The median follow-up time was 44 months (range 8 - 120). The median TTP was 4 months (range 1 - 43), and median survival time was 8 months (range 1 - 43). The 1 year and 2 year survival rate was 36.2% and 17.5%, respectively. According to univariate analysis, there was a worse prognosis when patients with multiple primary site, well-differentiated tumor, more than one site of metastasis, fail to achieve responses, TTP ≤ 4 months and received less than 2 cycles of chemotherapy. Multivariate analysis showed that TTP ≤ 4 months was the only independent prognostic factor for this group of patients.

Conclusions: Platinum analogue-based chemotherapy was the standard of care for advanced ESCC. There was a trend to improve the outcomes with platinum analogue combined with new drugs. Randomized trial with large samples was need.