多西他赛与紫杉醇在食管癌放化疗中的对照研究

目的：比较食管癌放化疗中多西他赛或紫杉醇化疗方案的疗效及毒副作用。方法：回顾分析92例食管癌患者临床资料,按照化疗方案的不同分为A、B两组。A组（36例）化疗方案：顺铂25 mg·m-2,第2、3、4天静脉滴注,多西他赛85 mg·m-2,第1天静脉滴注。B组（56例）化疗方案：顺铂25 mg·m-2,第2、3、4天静脉滴注,紫杉醇135 mg·m-2,第1天静脉滴注。比较两组患者的近期疗效、远期疗效及毒性反应。结果：近期有效率A组为91.7%,B组为96.4%;1、2年生存率A组为73%、54%,B组为68%、51%,两组差异均无统计学意义（P〉0.05）。治疗毒性多为轻度（Ⅰ＋Ⅱ级毒性）,神经毒性方面A组（8.3%）明显少于B组（37%）,差异有统计学意义（Z=-3.186,P=0.001）。结论：调强放疗同步多西他赛加顺铂方案与紫杉醇联合顺铂方案在治疗食管癌同步放疗中疗效相近,但多西他赛神经毒性偏低。

Case-control study of chemotherapy and radiotherapy for esophageal cancer with docetaxel and paclitaxel

Objective： To compare the efficacy and side effects of esophageal cancer chemotherapy in different chemotherapy regimens. Methods： The clinical data of 92 patients with esophageal cancer were retrospectively analyzed,and were divided into two groups according to different chemotherapy regimens. Group A： Intravenous drip with cisplatin 25 mg · m-2on the 2,3,4-day,with docetaxel 85 mg · m-2on the 1st day; Group B：Intravenous drip with cisplatin 25 mg·m-2on the 2,3,4-day,with paclitaxel 135 mg·m-2on the 1st day. Term efficacy,long-term efficacy and toxicity of patients were analyzed between the two groups. Results： For short-term efficacy,remission rate（ CR ＋ PR） of the group A and group B was 91. 7% and 96. 4%,1-year survival rate and2-year survival rate of group A was 73% and 54%,1-year survival rate and 2-year survival rate of group B was68% and 51%,there was no significant statistic difference between the two groups. For toxicity,most of cases showed slight toxicity（ grade Ⅰ-Ⅱ toxicity）. For neurotoxicity,group A（ 8. 3%） was significantly less than group B（ 37%）,there was significant statistic difference（ Z =-3. 186,P = 0. 001）. Conclusions： Docetaxel plus cisplatin and paclitaxel plus cisplatin have similar efficacy during IMRT treatment of esophageal cancer,but docetaxe appears lower neurotoxicity. Docetaxel plus cisplatin has more clinical advantages over paclitaxel plus cisplatin for IMRT of esophageal cancer treatment.