依托泊甙联合顺铂治疗食管小细胞癌的疗效

目的观察依托泊甙（VP-16）联合顺铂（DDP）治疗食管小细胞癌的疗效及不良反应。方法局限期（LD）患者7例,广泛期（ED）患者9例，所有患者均接受VP-16／DDP方案联合化疗。结果LD组CR 1例（14%），PR 4例（57%），PD 1例（14%），总有效率71%（CR+PR）；ED组：CR 0例，PR 5例（56%），总有效率56%（CR+PR）。LD组：中位至疾病进展时间（TTP）19月（95%CI：6.1~25.1月），中位生存时间（OS）24.7月（95%CI：10.5~36.7月）。ED组：中位至疾病进展时间（TTP）8.2 月（95%CI：5.7~16.9 月），中位生存时间（OS）12.5月（95%CI：9.5~25.1月）。LD组和ED组中非血液学毒性发生率最高的是消化道反应，Ⅰ~Ⅱ级恶心呕吐发生率分别为：72%和44%；Ⅲ~Ⅳ级白细胞减少的发生率分别为43%和33%；本研究中无治疗相关性死亡。结论依托泊甙联合顺铂治疗食管小细胞癌疗效显著，耐受性好。

VP-16/DDP Combination as A First-line Regimen for Esophageal Small Cell Carcinoma

ObjectiveTo evaluate the efficiency and safety of combination therapy with VP-16 and Cisplatin in esophageal small cell carcinoma.MethodsSeven of the sixteen patients were staged limited (LD) disease,the other nine patients were staged extend disease (ED).All the patients received etoposide 100 mg/m2 2 h infusion from d1 to d3 combined with Cisplatin 80 mg/m2 2 h infusion on d1,and the regimen was repeated every three weeks.Concurrently,the patients with limited disease received radiation therapy: 50 Gy,in daily doses of 2 Gy,5 d/w.ResultsIn LD group,there was 1 patient experienced CR,4 patients PR (57.1%),and the ORR was 71%(CR+PR).The TTP was 19 months,and OS was 24.7 months.While in ED group, no patient was CR,5 patients PR (56%),and the ORR was 56%.The TTP was 8.2 months,and OS was 12.5 months.Both in LD group and ED group there were grade 3~4 hematological toxicity: loucopenia(43% vs. 33%).No hematological toxicity consisted mainly of grade 1~2 nausea/vomiting（72% vs. 44%）.Furthermore,no treatment-related deaths were observed.ConclusionThe combination of VP-16 and DDP appears to be effective therapy for esophageal small cell carcinoma with acceptable toxicity.