Abstract: Objective To observe the effect of thalidomide on the short-term effect and therapy-related adverse reactions in the elderly patients with esophageal carcinoma treated with concurrent chemoradiotherapy. Methods A total of 100 elderly patients with esophageal carcinoma treated in Quanzhou First Hospital from June 2018 to February 2021 were randomly divided into the control group and the experimental group.Both groups were treated with IMRT(intensity modulated radiotherapy) and the same chemotherapy protocol: Paclitaxel 135 mg/m², day 1;Cisplatin, 25 mg/m²,day 1-3, once every three weeks for two cycles. The experimental group was given 100 mg of thalidomide orally before bedtime from the beginning to the end of radiotherapy.The efficacy and related adverse reactions were compared between the two groups. Results There were no significant differences in objective effective rate and disease control rate between the two groups (92% vs 90%, 98% vs 96%; P>0.05). The incidence rates of nausea, vomiting, and muscle and joint pain in the experimental group were significantly lower than those in the control group(P＜0.05). There were no significant differences in the incidence rates of leukopenia, thrombocytopenia, decreased hemoglobin, abnormal liver function and peripheral neurotoxicity between the two groups (P>0.05).The incidence rates of radiation esophagitis of grade Ⅰ-Ⅱ and Ⅲ-Ⅳ in the experimental group were lower than those in the control group (P＜0.05). Conclusions Thalidomide can significantly reduce the incidence of radiation esophagitis, nausea, vomiting, and muscle and joint pain during concurrent chemoradiotherapy.

Key words: thalidomide, esophageal cancer, radiotherapy, radiation esophagitis, chemotherapy, aged