不同铂类化疗方案对中晚期食管癌调强适形放疗患者的预后影响  

Effect of different platinum chemotherapy regimens on prognosis of patients with advanced esophageal carcinoma treated by intensity modulation radiation therapy

作　　者：童华杰[1] 张远强[1] 杨纯平 张忠杰[2] TONG Hua-jie;ZAHNG Yuan-qiang;YANG Chun-ping;ZHANG Zhong-jie(Department of Cardiothoracic Surgery,First People's Hospital of Zigong City,Zigong 643000,Sichuan Province,China;Department of Cardiothoracic Surgery,Affiliated Hospital of Luzhou Medical College, Luzhou 646000,Sichuan Province, China)

机构地区：[1]自贡市第一人民医院胸心外科,四川自贡643000 [2]泸州医学院附属医院胸心外科,四川泸州646000

出　　处：《中国临床药理学杂志》2019年第1期20-23,共4页The Chinese Journal of Clinical Pharmacology

基　　金：四川省卫生厅科研课题基金资助项目(130361)

摘　　要：目的分析紫杉醇联用不同铂类药物化疗对中晚期食管癌调强适形放疗患者生存预后影响的危险因素。方法将171例中晚期食管癌调强适形放疗患者根据化疗方案分为A组40例,B组26例,C组61例和D组44例。4组患者均予以125 mg·m^(-2)紫杉醇,静脉滴注,第1天。在此基础上,A组予以75mg·m^(-2)顺铂,静脉滴注,第2天; B组予以80~100 mg·m^(-2)奈达铂,静脉滴注,第2天; C组予以130 mg·m^(-2)奥沙利铂,静脉滴注,第2天; D组予以50mg·m^(-2)洛铂,静脉滴注,第2天。4组患者一个周期均为3周,均接受4个周期的化疗。分析年龄、性别、民族、食管癌家族史、不同化疗方案、肿瘤部位、体积、分化程度和转移淋巴结最大直径对食管癌患者预后的影响。结果 A,B,C,D的1年存活率分别为77. 50%(31例/40例),80. 77%(21例/26例),78. 69%(48例/61例)和81. 82%(36例/44例),2年存活率分别为60. 00%(24例/40例),57. 69%(15例/26例),57. 38%(35例/61例)和54. 54%(24例/44例),3年存活率分别为50. 00%(20例/40例),46. 15%(12例/26例),49. 18%(30例/61例)和47. 73%(21例/44例),差异均无统计学意义(均P> 0. 05)。Logistic多因素分析结果显示,食管癌患者的肿瘤体积和转移淋巴结最大直径是影响患者预后的独立危险因素。结论不同铂类药物的化疗方案对食管癌中晚期调强适形放疗患者的预后无显著影响,但肿瘤体积和转移淋巴结最大直径是影响食管癌中晚期调强适形放疗患者预后的独立危险因素。Objective To analyze the effect of paclitaxel combined with different platinum chemotherapy on survival and prognosis of patients with advanced esophageal carcinoma treated by intensity modulation radiation therapy.Methods According to the chemotherapy regimen,171 patients with advanced esophageal carcinoma treated by intensity modulation radiation therapy were divided into group A(n=40 cases),group B(n=26 cases),group C(n=61 cases)and group D(n=40 cases).Four groups were given 125mg·m^-2 paclitaxel,intravenous infusion,day 1.On this basis,group A was given 75mg·m^-2 cisplatin,intravenous drip,day 2, group B was given 80-100mg·m^-2 nedaplatin,intravenous drip,day 2,group C was given 130mg·m^-2 oxaliplatin,intravenous drip,day 2,group D was given 50mg·m^-2 lobaplatin,intravenous drip,day 2.Four groups were treated for 4 cycles with 3 weeks per cycle.The influences of age,sex,family history of esophageal cancer,different chemotherapy regimen,tumor location,size,degree of differentiation and the maximum diameter of metastatic lymph node on the prognosis of patients with esophageal cancer were analyzed.Results The survival rates of groups A,B,C and D were compared: the 1-year survival rates were 77.50%(31 cases/40 cases),80.77%(21 cases/26 cases),78.69%(48 cases/61 cases)and 81.82%(36 cases/44 cases),the 2-year survival rates were 60.00%(24 cases/40 cases),57.69%(15 cases/26 cases),57.38%(35 cases/61 cases)and 54.54%(24 cases/44 cases),the 3-year survival rates were 50.00%(20 cases/40 cases),46.15%(12 cases/26 cases),48.18%(30 cases/61 cases)and 47.73%(21 cases/44 cases),there were no significant differences among four groups(all P >0.05).Logistic multivariate analysis showed that tumor size and the maximum diameter of metastatic lymph nodes were independent risk factors for prognosis in patients with esophageal cancer.Conclusion The chemotherapy regimens of different platinum drugs have similar prognosis for patients with advanced intensity-modulated radiotherapy for esophageal cancer,while the tumor volume and

关 键 词：顺铂注射液 注射用奈达铂 奥沙利铂注射液 注射用洛铂 紫杉醇注射液 食管癌 预后 独立危险因素 

分 类 号：R979.1[医药卫生—药品]