周剂量紫杉醇联合顺铂同步调强放疗治疗局部晚期食管癌的疗效分析  

Clinical efficacy of synchronous intensity modulated radiation therapy combined with weekly dose of paclitaxel and cisplatin for locally advanced esophageal cancer

作　　者：陈广家 黄德波[1] 

机构地区：[1]泰安市肿瘤防治院放疗科,山东泰安271000

出　　处：《临床肿瘤学杂志》2016年第9期800-804,共5页Chinese Clinical Oncology

基　　金：泰安市科技发展计划项目(2015NS1127)

摘　　要：目的探讨周剂量紫杉醇联合顺铂同步调强放疗(IMRT)治疗局部晚期食管癌的疗效及安全性。方法 2010年1月至2015年4月36例初诊局部晚期食管癌患者接受周剂量紫杉醇联合顺铂同步IMRT治疗,具体方案:紫杉醇50mg/m^2静滴,顺铂25 mg/m^2静滴,均为每周1次;IMRT:60 Gy/30次,每周5次。采用RECIST 1.1版标准评价客观疗效,采用国立癌症研究所毒性判定标准(NCI CTC)4.0评价化疗毒性反应,同时随访其生存情况。结果 29例(80.6%)患者完成了治疗计划,36例患者均可评价疗效,其中17例获CR,13例PR,4例SD,2例PD,有效率和疾病控制率分别为83.3%和94.4%;中位无进展生存期为13.0个月,中位总生存期为25.0个月,1、2、3年生存率分别为77.8%、63.9%和33.3%。3级以上毒性反应包括白细胞减少(25.0%)、粒缺性发热(11.1%)、厌食(27.8%)和食管炎(25.0%)。结论周剂量紫杉醇联合顺铂同步IMRT治疗局部晚期食管癌的疗效确切,不良反应可以耐受,是一种有前景的治疗方案。Objective To investigate the efficacy and safety of synchronous intensity modulated radiation therapy（ IMRT）combined with weekly dose of paclitaxel and cisplatin for locally advanced esophageal cancer. Methods From January 2010 to April2015,36 patients with previously untreated locally advanced esophageal cancer were assigned to receive weekly paclitaxel（ 50 mg / m2）and cisplatin（ 25 mg / m2） plus concurrent IMRT. The total radiation dose was 60 Gy in 30 fractions with 5 fractions a week. Response to radiochemotherapy was assessed by RECIST criteria 1. 1 and toxicity was evaluated according to National Cancer Institute Common Toxicity Criteria 4. 0. The clinical follow-up data from radiochemotherapy were investigated. Results All patients were available for evaluation. Seventeen got complete response,13 cases had partial response,4 cases had stable disease and 2 cases had progressive disease. The response rate was 83. 3% and the disease control rate was 94. 4%. Of the 36 patients,the median progression-free survival was 13. 0 months and median overall survival was 25. 0 months. The 1-,2-,3-year survival rates were 77. 8%,63. 9% and 33. 3%.Grade 3 or higher major toxicity consisted of leukopenia（ 25. 0%）,febrile neutropenia（ 11. 1%）,anorexia（ 27. 8%） and esophagitis（ 25. 0%）. Conclusion The IMRT combined with weekly dose of paclitaxel and cisplatin is effective and tolerated in the treatment of locally advanced esophageal cancer.

关 键 词：食管癌 调强放疗 周剂量 紫杉醇 顺铂 

分 类 号：R730.5[医药卫生—肿瘤] R735.1[医药卫生—临床医学]