奈达铂或顺铂联合紫杉醇同步放化疗局部晚期食管癌的近期疗效比较

目的探讨奈达铂替代顺铂与紫杉醇化疗联合同步放疗局部颈段食管癌的疗效及耐受性。方法实验组（TN组）30例,采用紫杉醇135 mg/m2,静脉滴注,第1天,奈达铂100 mg/m2静脉滴注,第1天,诱导化疗,每3周为1个化疗周期,共2个疗程,同期行根治性放疗。对照组（TP组）30例,采用顺铂（30 mg/m2第1～3天）代替奈达铂,其余治疗方法同实验组。结果有效率实验组和对照组分别是66.7%和64.0%,P〉0.05,差异无统计学意义;不良反应显示实验组和对照组白细胞减少的发生率分别为53.3%（16/30）和48.0%（12/25）,贫血发生率分别为26.7%（8/30）和36.0%（9/25）,血小板下降的发生率分别为40.0%（12/30）和32.0%（8/25）,肝功损害发生率分别是6.7%（2/30）和12.0%（3/25）,实验组和对照组比较,P〉0.05,差异均无统计学意义。由于对照组将顺铂分为3日小剂量连续使用,故2组肾毒性发生率都很低,差异无统计学意义。恶心呕吐发生率实验组明显低于对照组,差异有统计学意义。结论奈达铂联合紫杉醇结合同步放疗治疗局部颈段食管癌疗效确切,且患者耐受性良好。

Nedaplatin or Cisplatin Plus Paclitaxel in Concurrent Chemoradiotherapy for Locally Advanced Esophageal Carcinoma Compared

Objective To explore the the efficacy and toxicities of nedaplatin or cisplatin and paclitaxel combined with radiotherapy in the treatment of patients with locally advanced esophageal cancer.Methods Patients in the experimental group（TN group,30 cases） were treated with intravenous infusion of paclitaxel 135 mg/m2 and nedaplatin 100 mg/m2 every 3 weeks for 2 cycles,and concurrent radical radiotherapy.Patients in the control group（TP group,30 cases） were treated with cisplatin（30 mg/ m2 day1-3） intravenously instead of nedaplatin,and the rest of the treatment were the same as the experimental group.Results The response rates in the two groups were 66.7% and 64.0%（P 0.05） and the difference was not statistically significant.Hematological toxicities were not significantly different in the experimental group and control group,which included leukopenia in 53.3%（16/30） and 48.0 %（12/25）,anemia in 26.7%（8/30） and 36.0%（9/25）（P 0.05）,thrombocytopenia in 40.0%（12/30） and 32.0%（8/25）（P 0.05）,there was no significant difference in liver damage,as cisplatin was divided into 3 doses of continuous use,so renal toxicity were very low in both groups and was not statistically significant.The incidence of nausea and vomiting was significantly lower in the experimental group than that in the control group,the difference was statistically significant.Conclusion Radiotherapy combined with nedaplatin and paclitaxel is effective for local esophagus with tolerable toxicities.