摘要
目的观察分析紫杉醇24h持续静脉滴注联合奥沙利铂（L-OHP）治疗晚期食管癌的近期疗效和安全性。方法43例TNM分期为Ⅲ一Ⅳ期晚期食管癌患者中，鳞癌32例，腺癌11例，36例为初治患者，7例曾接受过化疗，其中4例接受过紫杉类治疗，中位年龄56岁。紫杉醇175mg／m^2，24h持续静脉滴注，第2天L—OHP 130mg／m^2静脉滴注，21d为1个周期。结果43例患者共完成130个化疗周期，可评价疗效及毒副反应41例，完全缓解（CR）4例，部分缓解（PR）16例，疾病稳定（SD）9例，疾病进展（PD）12例，有效率（RR）48．7％。其中鳞癌可评价者30例，CR4例，PR14例，SD4例，PD8例，RR 60．0％，腺癌可评价者11例，CR 0例，PR 2例，SD 5例，PD 4例，RR18．2％，经统计分析鳞癌有效率显著高于腺癌组（P〈0．05），该方案主要的不良反应为中性粒细胞减少，Ⅲ-Ⅳ度41．4％，脱发、周围神经毒性、肌肉关节痛等，多以Ⅰ～Ⅱ度为主，发生率分别为60．9％，22％，19．5％。结论紫杉醇24h持续静脉滴注联合L-OHP治疗晚期食管癌近期疗效肯定，毒副反应耐受性好，可以考虑作为晚期食管癌的治疗方案。
Objective To evaluate the efficacy and safety of a 24-hour continuous infusion of paclitaxel in combination with oxaliplatin in the treatment of advanced esophageal cancer. Methods A total of 43 subjects with Ⅲ - Ⅳ stage advanced esophageal cancer were enrolled from March 2008 to June 2009. There were squamous cell carcinoma （ n = 32） and adenoearcinoma （ n = 11 ）. Among them, 36 patients had no prior chemotherapy, 7 patients received adjuvant chemotherapy and 4 accepted taxane-based regiments. The median age was 56 years old. All patients were treated with paclitaxel 175 mg/m^2 by a 24-hour continuous infusion, oxaliplatin 130 mg/m2 at Day 2, 3 weeks as one cycle. Results Forty-three patients completed 130 cycles （median： 3）. And the efficacy and safety of 41 patients could be evaluated. According to the WHO standard, there were complete response （CR） （n = 4） , partial response （PR） （n = 16）, stable disease （SD） （n =9）, progressive disease （PD） （n = 12） and response rate （RR） 48.7%. Thirty cases of squamous cell carcinoma could be evaluated, CR 4, PR 14, SD 4, PD 8, RR 60. 0% ; Adenocarcinoma CR 0, PR 2, SD 5, PD 4, RR 18. 2%. Statistical test show that RR of squamous was higher than that of adenocarcinoma （ P 〈 0. 05）. The most common toxicity was hematological. Grade Ⅲ - Ⅳ neutropenia was seen in 16 patients （41.4%）, alopecia 60.9% , vomiting 26. 8%, neuropathy 22% and myalgia 19. 5%. Most of them were of Grade Ⅰ - Ⅱ . Conclusions The efficacy of a 24-hour continuous infusion of paclitaxel plus oxaliplatin in the treatment of advanced esophageal cancer is excellent. All toxicities are well tolerated. So this protocol may be considered a main regimen in the treatment of advanced esophageal cancer.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2010年第28期1986-1988,共3页
National Medical Journal of China
关键词
食管肿瘤
紫杉酚
持续静脉滴注
奥沙利铂
Esophageal neoplasms
Paclitaxel
Continuous infusion
Oxaliplatin
