白蛋白结合型紫杉醇联合顺铂同期放射治疗对初治局部晚期食管鳞状细胞癌的疗效及安全性  

Efficacy and safety of albumin-binding paclitaxel,cisplatin combined with concurrent radiotherapy in the treatment of locally advanced esophageal squamous cell carcinoma

作　　者：王铃燕 王兴丹 王向前[1] WANG Lingyan;WANG Xingdan;WANG Xiangqian(Department of Radiotherapy,Affiliated Cancer Hospital of Nantong University,Nantong Jiangsu 226351,China)

机构地区：[1]南通大学附属肿瘤医院放射治疗科,江苏南通226351

出　　处：《临床与病理杂志》2023年第7期1333-1340,共8页Journal of Clinical and Pathological Research

基　　金：南通市科技局课题(MSZ20210)。

摘　　要：目的:探究白蛋白结合型紫杉醇联合顺铂同期放射治疗(以下简称“放疗”)对初治局部晚期食管鳞状细胞癌(esophageal squamous cell carcinoma,ESCC)的疗效及安全性。方法:纳入2019年1月至2020年12月于南通大学附属肿瘤医院初次治疗的100例局部晚期ESCC患者作为研究对象。接受顺铂联合白蛋白结合型紫衫醇(cisplatin plus albumin bound taxol,TP)+同期放疗方案治疗的50例患者入选TP组,接受顺铂联合5-氟尿嘧啶(cisplatin plus5-fluorouracil,FP)+同期放疗方案治疗的50例患者入选FP组。治疗后,通过计算客观缓解率(objective response rate,ORR)和疾病控制率(disease control rate,DCR)评价2组短期疗效。测定和比较治疗前后2组患者血管内皮生长因子(vascular endothelial growth factor,VEGF)和鳞状细胞癌(squamous cell carcinoma antigen,SCC)抗原的水平变化。观察和记录2组患者接受治疗后的不良反应。定期随访2组患者的生存情况,分析无进展生存期(progression-free survival,PFS)。采用logistic回归分析影响TP方案+同期放疗预后的因素。结果:治疗后,TP组的ORR显著高于FP组(分别为82.00%和62.00%,P<0.05)。TP组的VEGF、SCC抗原表达水平均显著低于FP组(均P<0.05)。2组患者的血液毒性反应发生情况比较,差异均无统计学意义(均P>0.05);在非血液毒性反应中,TP组恶心呕吐的发生率显著低于FP组(P<0.05)。生存情况分析结果显示:TP组的PFS显著长于FP组(P=0.031)。Logistic回归分析影响TP+同期放疗方案预后的因素,结果显示:临床TNM(clinical TNM,c TNM)分期、PS评分是影响ESCC患者预后的独立危险因素(均P<0.05)。结论:TP+同期放疗方案对局部晚期ESCC患者疗效较好,不良反应可耐受,可改善生存情况。cTNM分期可显著影响该治疗方案的预后。Objective:To explore the efficacy and safety of albumin-binding paclitaxel and cisplatin combined with concurrent radiotherapy in the treatment of locally advanced esophageal squamous cell carcinoma(ESCC).Methods:A total of 100 patients with locally advanced esophageal squamous cell carcinoma who received initial treatment in Affiliated Cancer Hospital of Nantong University from January 2019 to December 2020 were included as subjects.Fifty patients who received cisplatin plus albumin bound taxol(TP)+concurrent radiotherapy were enrolled in the TP group.Fifty patients who received cisplatin plus 5-fluorouracil(FP)+concurrent radiotherapy were included in FP group.After the treatment,the short-term efficacy between the 2 groups was evaluated by calculating the objective response rate(ORR)and disease control rate(DCR),and the levels of tumor markers[vascular endothelial growth factor(VEGF)and squamous cell carcinoma(SCC)antigen]were measured.The adverse conditions between the 2 groups were observed and recorded after treatment.The survival of both patients was followed up periodically and the progression-free survival(PFS)was analyzed.Logistic analysis of the factors affecting the prognosis of TP regimen+concurrent radiotherapy was performed.Results:After the treatment,the ORR of the TP group was 82.00%,which was significantly higher than that of the FP group(62.00%,P<0.05).The expression levels of VEGF and SCC antigen in the TP group were significantly lower than those in the FP group(both P<0.05).No significant difference was observed in the occurrence of hematotoxic reactions between the 2 groups(all P>0.05),while the incidence of nausea and vomiting in the TP group was significantly lower than that in the FP group(P<0.05).The results of survival analysis showed that the PFS of the TP group was significantly longer than that of the FP group(P=0.013).Logistic analysis showed that clinical TNM(cTNM)stage and PFS score were statistically significant factors affecting the prognosis of ESCC patients(P<0.05).Conclusion

关 键 词：食管鳞状细胞癌 白蛋白结合型紫杉醇 顺铂 同期放疗 

分 类 号：R735.1[医药卫生—肿瘤]