Abstract
Objective To compare the supporting role and safety between the esophagus stent insertion and intravenous nutrition in the palliative chemotherapy for advanced esophageal squamous cell carcinoma. Methods From May 2010 to May 2014, 127 patients with advanced esophageal cancer who met the indication of palliative chemotherapy were enrolled and were randomized divided into stent group (SG) and peripheral intravenous nutrition group (PING) by using random number table method. The differences of mean chemotherapy cycle, response rate (RR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and adverse events between both groups were analyzed. Results The mean chemotherapy cycles of SG and PING were (3.219±1.240) cycles and (2.556±1.118) cycles, respectively. There were no significant statistical differences on RR [15.63% (10/64) vs. 11.11% (7/63), P=0.445] and media PFS [3.0 months (2.568-3.432 months) vs. 3.0 months (2.488-3.512 months), P=0.542] between SG group and PING group, while SG group had more advantages in DCR [34.38% (22/64) vs. 17.46% (11/63), P=0.030] and OS [9.0 months (8.044-9.956 months) vs. 8.0 months (7.279-8.721 months), P=0.042]. The incidence rates of gradeⅠesophagalgia and gradeⅠor Ⅱesophageal reflux in SG group were higher than those in PING group (P<0.05), but the incidence rates of grade Ⅰ constipation, grade Ⅱ esophageal perforation or fistula, grade Ⅱ or Ⅲ dysphasia, grade Ⅲ esophageal hemorrhage, grade Ⅰ or Ⅱtransfusion related reaction and grade Ⅰ or Ⅱ infectious phlebitis were contrary (all P<0.05). Conclusion Compared with intravenous nutrition support therapy in the advanced esophageal cancer, stent implantation followed by palliative chemotherapy is an efficient way to improve efficacy and prolong the OS, and its main adverse events are mild and well-tolerated. Key words: Esophageal neoplasms; Carcinoma, squamous cell; Esophagus stent; Intravenous nutrition; Palliative chemotherapy
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