紫杉醇联合顺铂治疗晚期食管鳞癌临床观察

目的 观察紫杉醇联合顺铂治疗晚期食管鳞癌的疗效及不良反应.方法 用紫杉醇注射液175mg/m2静脉滴注3h,第1天；顺铂25mg/m2,静脉滴注,第1-3天.该方案治疗25例晚期食管鳞癌,3周为1个周期.结果 25例患者共完成化疗周期数为104个,其中完全缓解1例(4.1％),部分缓解10例(41.7％),稳定9例(37.5％),进展4例(16.7％),总有效率为45.8％(11/24).至末次随访,死亡20例,全组中位生存期11.0个月(95％CI:8.35～13.65个月),1年生存率37.3％.12例治疗有效病例的中位生存期为12.5个月(95％CI:9.11～ 15.90个月),治疗无效病例的中位生存期为8.0个月(95％CI:5.50～9.50个月),获治疗有效病例的中位生存期显著好于无效病例(P =0.022).主要毒副反应有:白细胞减少(Ⅲ度7例,Ⅳ度1例)、中性粒细胞减少(Ⅲ度5例,Ⅳ度1例)、血小板下降(Ⅲ度1例)和脱发(Ⅱ度19例).结论 紫杉醇联合顺铂方案治疗晚期食管癌有效安全,可作为晚期食管鳞癌首选化疗方案.

Clinical observation of paclitaxel and cisplatin protocol for treatment patients with advanced or metastatic squamous-cell carcinoma of the esophagus(ESCC)

Objective To evaluate the efficacy and safety of paclitaxel plus cisplatin combination in treatment patients with advanced or metastatic squamous-cell carcinoma of the esophagus （ ESCC）. Methods Twenty-five patients with advanced or metastatic ESCC received paclitaxel 175mg/m2 by 3-hour infusion on day 1 and cisplatin 25mg/m2 by infusion on day 1 - 3.3 weeks as one cycle. Results Twenty-four patients were eligible to be evaluated the efficacy and safety. The overall response rate was 45.8% with complete and partial response rates of 4.1% and 41.7% ,respectively. The median survival time of all patients was 11 months （95% CI：8.35 -13.65 months）. There was significant difference in the median overall survival between the patients who had showed response versus those who bad not （ P = 0. 022）. Median survival was 12.5 months （95% C1：9.11 - 15.90 months） and 8 months （ 95 % CI ： 5.50 - 9.50 months） ,respectively. The 1-year survival probability was 37.3%. The most common toxicities were leukopenia, neutropenia,thrombocytopenia and alopecia. Conclusion The effect of paclitaxel and cisplatin which seems beneficial as first-line therapy in advanced squamous-cell carcinoma of the esophagus had a high effective rate with acceptable toxicity.