紫杉醇脂质体联合奈达铂治疗晚期食管癌的临床观察  

Clinical observation of paclitaxel liposome combined with nedaplatin in treatment of advanced esophageal cancer

作　　者：罗金红[1] 周俊[1] 林昀[1] 李琦[1] 林根来[2] 高勇[1] 

机构地区：[1]同济大学附属东方医院肿瘤内科,上海200120 [2]复旦大学附属中山医院放疗科,上海20003

出　　处：《肿瘤》2011年第12期1093-1098,共6页Tumor

基　　金：上海市浦东新区卫生系统重点学科建设资助项目(编号:PWZXK2007-06);上海市浦东新区卫生系统中青年业务骨干培养基金资助项目

摘　　要：目的:评价紫杉醇脂质体联合奈达铂治疗晚期食管癌的临床疗效和不良反应。方法:42例晚期食管癌患者接受紫杉醇脂质体(每周135mg/m2)联合奈达铂(每周80mg/m2)治疗,21d为1个化疗周期。所有患者均至少接受2个周期的化疗,每2个周期评价近期疗效和不良反应。随访生存情况,采用意向性治疗分析。结果:42例患者中有41例可评价近期疗效,其中完全缓解1例(2.4%),部分缓解16例(38.1%),稳定14例(33.3%),疾病进展10例(23.8%),总有效率为40.5%(17/42)。18例初治患者的总有效率为55.6%,24例复治患者的总有效率为29.2%。1年总生存率为42.6%,中位无进展时间为6.3个月,中位总生存时间为11.3个月。常见的不良反应主要为血液学不良反应,7例患者发生3～4度中性粒细胞减少,4例患者发生3度血小板减少。3～4度呕吐发生率为7.3%(3/41),无化疗相关性死亡病例。结论:紫杉醇脂质体联合奈达铂治疗晚期食管癌疗效确切,不良反应较轻,值得在临床上对此开展进一步的研究。Objective： To evaluate the efficacy and toxicity of paclitaxel liposome combined with nedaplatin as first-line chemotherapy for patients with advanced esophageal cancer. Methods： A total of 42 patients with pathologically confirmed advanced esophageal cancer were recruited into this study. On day 1, the patients were intravenously infused with 135 mg/m2 paclitaxel liposome followed by nedaplatin 80 mg/m2. This chemotherapy regimen was repeated every three weeks until the documented disease progression, unacceptable toxicity or patients＇ refusal. All patients received at least two cycles of chemotherapy, and the short-term response and toxicity were evaluated every two cycles. The patients were followed-up, and the survival was analyzed. The intention-to-treat analysis was applied. Results： Forty-one of the 42 patients were assessable for short-term response. The overall response rate was 40.5% （1 7/42） including complete response in one patient （2.4%） and partial response in 16 patients （38.1%）. Fourteen patients （33.3%） received stable disease, and ten patients received progressive disease （23.8%）. The overall response rates of chemotherapy in naive patients （n=18） and relapsed patients （n=24） were 55.6% and 29.2%, respectively. The estimate of overall one-year survival rate was 42.6%. The median time to progression and the median overall survival time were 6.3 months and 11.3 months, respectively. The common adverse reaction was hematologic toxicity including 7 patients with grade 3/4 neutropenia and 4 patients with grade 3 thrombocytopenia. The main non-hematologic toxicity was grade 3/4 vomiting in 3 patients（7.3%）. No toxicity-related death occurred. Conclusion： The combined therapy of paclitaxel liposome and nedaplatin is effective and well tolerated in patients with advanced esophageal cancer.

关 键 词：食管肿瘤 奈达铂 紫杉醇脂质体 

分 类 号：R735.1[医药卫生—肿瘤]