Abstract:Objective To compare the efficacy and safety of cisplatin combined with paclitaxel or 5-fluorouracil and concurrent radiotherapy for elderly patients with advanced esophageal cancer. Methods A total of 102 elderly patients with advanced esophageal cancer who were treated in our hospital from May 2016 to June 2018 were recruited as the research objects, and then randomly divided into paclitaxel group (n=52) and 5-fluorouracil group (n=50). The therapeutic efficiency, 2-year survival rate, gastrointestinal side effects, kidney and hepatic impairment and bone marrow suppression were compared and analyzed between the two groups. SPSS statistics 25.0 was used to perform the statistical analysis. Chi-square test and Fisher exact test were employed for data analyses, and Kaplan-Meier analysis and Log-rank test were adopted to evaluate clinical efficacy and safety of the regimens. Results The efficiency rate was 65.38% (34/52) and 62.00% (31/50) respectively in the paclitaxel group and 5-fluorouracil group (P>0.05). But the control rate was 94.23% (49/52) and 70.00% (35/50) respectively, with statistically difference between the two groups (P=0.032). There was no significant difference in 2-year survival rate (P>0.05). The incidences of nausea and vomiting, and bone marrow suppression were 40.38% (21/52) and 67.31% (35/52) respectively in the paclitaxel group, and 74.00% (37/50) and 28.00% (14/50) in the 5-fluorouracil group (P<0.05). The incidences of kidney and hepatic impairment did not differ between two groups. Conclusion The regimen of paclitaxel combined with cisplatin and concurrent radiotherapy shows a similar therapeutic efficacy as the regimen with 5-fluorouracil+cisplatin+concurrent radiotherapy for the elderly patients with advanced esophageal cancer, and causes less adverse reactions in gastrointestinal tract and less bone marrow suppression in the patients.