紫杉醇联合洛铂同期放疗治疗中晚期食管癌的临床近期疗效及安全性  

Short-term efficacy and safety of concurrent chemoradiotherapy with paclitaxel and lobaplatin for advanced esophageal cancer

作　　者：王涛[1] 杨俊省[1] 

机构地区：[1]山东省枣庄市立医院肿瘤科,277100

出　　处：《国际肿瘤学杂志》2015年第1期10-13,共4页Journal of International Oncology

摘　　要：目的 观察紫杉醇联合洛铂同期放化疗治疗中晚期食管癌的近期疗效和安全性.方法 68例中晚期食管癌患者根据随机数字表法随机分为紫杉醇联合洛铂同期放化疗组（TL组）和顺铂联合5-氟尿嘧啶、亚叶酸钙同期放化疗组（PF组）,放疗总剂量为60～ 70 Gy.放疗期间同步化疗2个疗程.TL组化疗剂量为紫杉醇60 mg/m2,第1天,每周1次,连用6～8周,洛铂30 mg/m2,第2天,每3周为1个周期.PF组化疗剂量为顺铂75 mg/m2,第1天,5-氟尿嘧啶500 mg/m2,第1～5天,亚叶酸钙200 mg/m2,第1～5天.结果 入组患者均可评价疗效.TL组与PF组同步放化疗结束时有效率分别为73.53％和50.00％,中位无进展生存时间分别为13.0个月和6.5个月,差异均有统计学意义（x2=4.023,P=0.040;x2 =4.512,P=0.034）.两组Ⅲ～Ⅳ度恶心呕吐发生率分别为5.88％和35.29％,Ⅲ～Ⅳ度白细胞下降发生率分别为20.59％和32.35％,两组Ⅲ～Ⅳ度血小板下降发生率分别为32.35％和8.82％,差异均有统计学意义（x2=8.500,P=0.003;x2=3.200,P =0.041;x2=6.710,P=0.016）.两组Ⅲ～Ⅳ度食管炎发生率分别为11.76％和17.65％,差异无统计学意义（x2=1.450,P =0.493）.结论 TL组治疗中晚期食管癌近期疗效肯定,不良反应可耐受,可以考虑作为中晚期食管癌的治疗方案.Objective To evaluate the short-term efficacy and safety of concurrent chemoradiotherapy （CCRT） with paclitaxel and lobaplatin for advanced esophageal cancer.Methods Sixty-eight patients with advanced esophageal cancer were randomly divided into two groups according to random number table method：CCRT with paclitaxel and lobaplatin （TL group） and CCRT with DDP and 5-Fu （PF group）.The CCRT regimen included radiotherapy at a total dose of 60-70 Gy,and concurrent paclitaxel 60 mg/m2 on d1,a fraction per week for 6-8 weeks,lobaplatin 30 mg/m2 on d2,a fraction per 3 weeks （TL group）,and concurrent DDP 75 mg/m2 on d1,5-Fu 500 mg/m2,d1-5,CF 200 mg/m2,d1-5 （PF group）.Results All 68 patients were evaluable for response.The response rates were 73.53％ in TL group and 50.00％ in PF group,the median progression-free survival were 13.0 months in TL group and 6.5 months in PF group.There were significant differences （x2 =4.023,P =0.040; x2 =4.512,P =0.034）.The incidence rates of Ⅲ-ⅣW degree nausea and vomiting,granulocytopenia and thrombocytopenia were 5.88％ and 35.29％,20.59％ and 32.35％,32.35％ and 8.82％,and the differences were statistically significant （x2 ＝ 8.500,P =0.003 ; x2 =3.200,P =0.041; x2 =6.710,P =0.016）.The incidence rates of Ⅲ-Ⅳ degree esophagitis in the two groups were 11.76％ and 17.65％,and there was no significant difference （x2 =1.45,P =0.493）.Conclusion The efficacy of TL group in the treatment of advanced esophageal cancer is excellent,and all toxicities are well tolerated.So this protocol may be considered a main regimen in the treatment of advanced esophageal cancer.

关 键 词：食管肿瘤 药物疗法 联合 紫杉醇 洛铂 

分 类 号：R735.1[医药卫生—肿瘤]