103P - Concurrent chemoradiotherapy with S-1 vs radiotherapy alone for older patients with esophageal cancer: A meta-analysis

Background

The latest cancer statistics show that esophageal cancer ranks 9th in incidence and 6th in mortality among all cancers. Concurrent radiochemotherapy (CCRT) based on fluorouracil and platinum is one of the standard treatments for advanced stage patients. However, concurrent chemoradiotherapy will bring relatively serious toxic and side reactions. Studies have shown that about 40% of esophageal cancer patients are older than 70 years old, and most of these patients are more unable to tolerate CCRT. S-1, as an oral fluorouracil preparation, has achieved good clinical efficacy in the treatment of cancer with mild side effects. At present, some clinical studies have applied S-1 combined with synchronous radiotherapy in the treatment of elderly esophageal cancer. However, the sample size of these studies is small, and the results of some studies are different or even contradictory.

Methods

The Cochrane Library, Pubmed, Embase, CBM, CNKI, VIP and Wanfang database were searched. The Meta-analysis was performed by the Revman 5.3 software.

Results

A total of 1639 patients were enrolled in 23 studies. The results showed that, in terms of short-term efficacy, the combination therapy increased the incidence of CR[OR=2.12, 95%-CI (1.65, 2.73), P < 0.00001] and PR[OR=1.53, 95%-CI (1.23, 1.90).P =0.0002] and total response rate [OR=3.47, 95%ci (2,69,4.49), p < 0.00001].In terms of long-term efficacy, the combination therapy improved 1-year survival rate [OR=2.56, 95%CI (1.94, 3.38), P < 0.00001] and 2-year survival rate [OR=2.33, 95%CI (1.77, 3.08), P < 0.00001].In terms of side effects, the incidence of leucopenia, thrombocytopenia, radioactive esophagitis, nausea and vomiting in the combination therapy was higher than that in the control group (P < 0.05), but there was no significant difference in the incidence of anemia and radiation pneumonia (P > 0.05).

Conclusions

Available evidence suggests that S-1 combined with concurrent radiotherapy improves short-term therapeutic efficacy and survival time, but also increases the incidence of treatment-related side effects in older patients with esophageal cancer.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The author.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.