健择联合顺铂合并放疗治疗进展期食管癌的临床研究  

Gemcitabine in combination with cisplatin and concurrent radiation therapy for advanced esophageal cancer

作　　者：曹小龙[1] 毛志达[2] 胡家柱[1] 张超[1] 郭添胜[1] 张力[2] 

机构地区：[1]广州市番禺区人民医院肿瘤科,广东广州511400 [2]中山大学肿瘤中心内科,广东广州511060

出　　处：《中华肿瘤防治杂志》2006年第15期1186-1187,共2页Chinese Journal of Cancer Prevention and Treatment

摘　　要：对41例初治进展期食管癌患者采用健择联合顺铂合并放射治疗。38例患者可以评估疗效和毒性。健择1000mg／m^2，静脉滴入，d1、d8；顺铂20mg／m^2，静脉滴入，d1～d4；同时合并放射治疗，每次2Gy，每周5次，共5周，总剂量为50Gy；化疗周期每21或28d重复。结果5例患者完全缓解，17例患者部分缓解，总有效率为58％；27例患者吞咽困难缓解，缓解率为71％；中位生存期为11．3个月；1、2年生存率分别为63％和45％；最常见的3、4度毒性是血小板下降（29％）、贫血（21％）、白细胞下降（24％）和食道炎（21％）；无治疗相关死亡和3、4度的神经毒性。初步研究结果提示，健择加顺铂合并放疗方案治疗进展期食管癌耐受性好，疗效显著，值得临床广泛推广应用。A total of 41 patients with chemoradiotherapy-naive advanced esophageal carcinoma were treated with gemcitabine plus cisplatin and concomitant radiotherapy. Thirty-eight patients were evaluative for toxicity and response, patients were treated with gemcitabine 1000mg/m2 on days 1,8 and cisplatin 20mg/m2 on days 1--4 with concomitant radiation administered at fractions of 2.0 Gy,5 days a week over 5 weeks. The chemotherapy cycles were repeated every 21 or 28 days. Five complete response and seventeen partial response were observed for an overall response rate of 58%;Relief of dysphagia was achieved in 71% （27/38） of the patients; The median survival was 11.3 months;One-year survival rate was 63 %0 ;Two-years survival rate was 45 %. The most frequent grade 3--4 toxicities were thrombocytopenia（ 29 % ）, anaemia（ 21% ）, leukopenia（ 24 % ） and esophagitis（ 21 % ） ; There were no treatment-related death and grade 3--4 neuropathy. In conclusion, those tentative research results cue that gemcitabine plus cisplatin and concurrent radiation therapy was well tolerated and had significant activity in patients with advanced esophageal cancer and the regimen deserve to be utilized widely in clinic.

关 键 词：食管肿瘤/放射疗法 食管肿瘤/药物疗法 顺铂/投药和剂量 脱氧胞苷/投药和剂量 

分 类 号：R735.1[医药卫生—肿瘤]