贝伐珠单抗联合多西他赛治疗Her-2阴性复发转移性乳腺癌的疗效观察

背景与目的:贝伐珠单抗是首个抗血管生成的分子靶向药物,可以与多种化疗药物联合用于治疗复发转移性乳腺癌.本研究旨在观察贝伐珠单抗联合多西他赛治疗复发转移性乳腺癌的疗效和不良反应.方法:28例Her-2阴性的复发转移性乳腺癌患者均接受贝伐珠单抗联合多西他赛方案治疗,多西他赛75 mg/m2静滴,第1天:同时给予贝伐珠单抗15 mg/kg,第1天;21 d为1个周期.每个周期评价疗效同时记录不良反应.结果:27例患者可评价疗效和不良反应,其中CR 1例,PR 21例,有效率(CR+PR)为81.5%.粒细胞减少及白细胞减少是主要的不良反应,Ⅳ度粒细胞减少发生率为85.2%.研究中观察到高血压3例,静脉血栓1例,分级均为1级.蛋白尿12例,鼻衄15例,均为1～2级.结论:贝伐珠单抗联合多西他赛是治疗Her-2阴性的复发转移性乳腺癌患者的有效方案,其不良反应能够耐受.     

曲妥珠单抗联合化疗治疗Her-2过表达转移性乳腺癌40例

[目的]观察曲妥珠单抗（trastuzumab）联合长春瑞滨（NVB）等化疗药物治疗Her-2过表达转移性乳腺癌患者的疗效和毒副反应。[方法]40例Her-2过表达转移性乳腺癌患者,其中Her（＋＋）17例,Her（＋＋＋）23例。曲妥珠单抗初始剂量为4mg/kg,以后每周1次,剂量为2mg/kg,不少于6周。NVB25mg/m2,d1;DDP70mg/m2,d1～3。每21d为1个周期。[结果]总有效率为60%,其中CR6例,PR18例;主要毒副反应为Ⅲ～Ⅳ度粒细胞减少及发热;未观察到明显的心脏毒性。[结论]曲妥珠单抗联合NVB为主的化疗方案治疗Her-2过表达转移性乳腺癌可行,毒副反应可耐受。     

曲妥珠单抗联合多西紫杉醇治疗Her-2/neu高表达转移性乳腺癌的疗效和不良反应

背景与目的:大约有20%～30%的乳腺癌患者Her-2/neu高表达,Her-2/neu高表达与患者的不良预后密切相关.化疗药物联合曲妥珠单抗可以显著提高Her-2/neu高表达乳腺癌患者的化疗有效率和生存率,多西紫杉醇是近年来治疗乳腺癌有效的化疗药物之一.本研究旨在观察曲妥珠单抗联合多西紫杉醇治疗Her-2/neu高表达转移性乳腺癌的疗效与不良反应.方法:22例Her-2/neu高表达转移性乳腺癌患者接受曲妥珠单抗联合多西紫杉醇方案治疗,曲妥珠单抗的首次剂量为8 mg/kg,以后的剂量为6 mg/kg.多西紫杉醇75mg/m2,每21 d重复一次.按WHO疗效评价标准评价疗效,按WHO化疗药物急性和亚急性不良反应评价标准评价不良反应.结果:全组22例患者共完成96个周期化疗(中位数3周期,范围2～6周期),所有患者均可评价疗效.22例患者中完全缓解2例,部分缓解12例,病情稳定4例,病情进展4例,客观有效率(CR PR)63.64%,中位疾病进展时间5.4个月,1年生存率59%.全组患者均可评价不良反应,主要不良反应为骨髓抑制,其中Ⅲ～Ⅳ度白细胞减少发生率为54.5%,部分患者有发热(第一次输注曲妥珠单抗时出现)和轻度的心肌劳损.结论:曲妥珠单抗联合多西紫杉醇方案治疗Her-2/neu高表达转移性乳腺癌近期疗效较高,不良反应轻,患者可以耐受.     

多西他赛联合贝伐珠单抗及其单药维持治疗转移性乳腺癌的临床观察

目的 探讨多西他赛联合贝伐珠单抗一线治疗序贯应用贝伐珠单抗单药维持治疗转移性乳腺癌的疗效和安全性。方法 8例转移性乳腺癌患者均为女性,年龄34～62岁,中位年龄为53岁,均经改良根治术后病理组织学确诊,免疫组化检查HER-2为（-）或（+）。治疗方案：贝伐珠单抗15mg／kg d1,多西他赛 75mg／m2 d1,3周为1周期。治疗6个周期未出现病情进展者应用贝伐珠单抗（15mg/kg）单药维持治疗,每3周1次。结果 全组8例中获CR 1例,PR 3例,SD 4例。有效率（RR）为50％,疾病控制率（DCR）为100％。7例经联合治疗6～9个周期后用贝伐珠单抗维持治疗,维持治疗时间为2～31.3个月,中位维持治疗时间为15.3个月,中位无进展生存期为22.3个月。全组5例发生3、4级中性粒细胞减少,其中2例伴发热;5例患者出现指甲毒性,其中3例1、2级,2例3级。贝伐珠单抗应用4～36.5个月过程中,1例发生血栓3级,1例高血压2级,1例高血压3级,2例蛋白尿2级。结论 多西他赛联合贝伐珠单抗一线治疗序贯应用贝伐珠单抗单药维持治疗HER 2阴性转移性乳腺癌的疗效好,毒副反应可耐受,值得临床进一步应用。     

曲妥珠单抗联合长春瑞滨治疗16例Her-2阳性转移性乳腺癌

[目的]观察曲妥珠单抗联合长春瑞滨治疗蒽环类/紫杉醇类治疗失败的人表皮生长因子受体-2（Her-2）阳性晚期乳腺癌的临床疗效。[方法]16例Her-2阳性转移性乳腺癌患者接受曲妥珠单抗首次8mg/kg,以后6mg/kg,每3周1次联合长春瑞滨25mg/m2,d2、d9,每3周为1周期,最多6个周期后如疾病无进展则改为曲妥珠单抗6mg/kg,每3周1次维持治疗至1年或疾病进展。[结果]16例患者全部可评价疗效,有效率62.5%,其中一线治疗有效率72.7%;中位疾病进展时间（TTP）9.3个月,1年、2年生存率分别为87.5%、56.3%。最常见毒副反应为血液学毒性。与曲妥珠单抗有关的毒副反应主要有发热、寒战以及左室射血分数（LVEF）下降。[结论]曲妥珠单抗联合长春瑞滨治疗Her-2阳性的蒽环类/紫杉醇类治疗失败的转移性乳腺癌有较好的疗效,毒副反应大多可耐受。     

雷替曲塞／贝伐珠单抗联合伊立替康或奥沙利铂方案治疗晚期结直肠癌的临床观察

目的 探讨含雷替曲塞／贝伐珠单抗的联合化疗方案在晚期结直肠癌二线及二线以上治疗中的疗效及安全性。方法 收集二线或二线以上治疗均采用含雷替曲塞／贝伐珠单抗联合伊立替康或奥沙利铂方案共15例晚期结直肠癌患者的资料,所有方案均以2周为1周期,其中采用雷替曲塞+贝伐珠单抗方案2例,雷替曲塞+贝伐珠单抗+伊立替康方案9例,雷替曲塞+贝伐珠单抗+奥沙利铂方案4例。贝伐珠单抗5mg／kg 静滴,d1;雷替曲塞2mg／m2静滴15min,d2;伊立替康180mg／m2静滴1h,d2;奥沙利铂85mg／m2静滴2h,d2。结果 15例患者均可评价疗效。获PR 2例,SD 10例,PD 3例,有效率为13.3％,疾病控制率为800％;中位无疾病进展时间为5.1个月（95％CI：3.404～6.813个月）,中位OS为11.5个月（95％CI：8.985～13.930个月）。毒副反应主要包括食欲减退、恶心呕吐、疲乏、白细胞减少和血小板减少等,3～4级毒副反应以食欲减退、恶性呕吐、疲乏和血小板减少为主。结论 含雷替曲塞／贝伐珠单抗联合伊立替康或奥沙利铂方案在晚期结直肠癌二线及二线以上治疗中的疾病控制率高,毒副反应可耐受,可推荐为Ⅲ期临床研究方案以及二线或二线以上晚期结直肠癌的治疗方案。     

贝伐珠单抗联合FOLFIRl方案一线治疗转移性结直肠癌的临床研究

目的评价贝伐珠单抗联合FOLFIRI方案一线治疗转移性结直肠癌的疗效和安全性。方法将42例转移性结直肠癌患者随机分为FOLFIRI组和FOLFIRI＋贝伐珠单抗组。FOLFIRI组（n=21）采用伊立替康（CPT一11,180mg／m2,d1）＋甲酰四氢叶酸钙（CF,400mg／m2,d1）＋氟尿嘧啶（5-FU,400mg／m2,静脉推注,d1;然后5-FU,2400mg／m2,以微量泵进行持续静脉滴注46小时）。FOLFIRI＋贝伐珠单抗组（n=21）采用贝伐珠单抗（每2周5mg／kg,d1）＋FOLFIRI方案。2周为1个周期,3个周期后评价疗效。两组患者均持续治疗至病情进展或毒性不能耐受。结果42例患者均可评价疗效和不良反应。FOLFIRI组和FOLFIRI＋贝伐珠单抗组的治疗有效率分别为28．6％和61．9％,FOLFIRI＋贝伐珠单抗组的有效率显著高于FOLFIRI组（P=0．03）。FOLFIRI＋贝伐珠单抗组的临床获益率明显高于FOLFIRI组（90．5％US61．9％,P：0．03）。FOLFIRI组和FOLFIRI＋贝伐珠单抗组中位无疾病进展时间（progression—freesurvival,PFS）分别为6．6个月和10．0个月（P=0．000）。两组的主要不良反应为迟发性腹泻和中性粒细胞减少,贝伐珠单抗组增加的不良反应主要有高血压（P=0．002）、出血（P=0．001）和蛋白尿（P=0．035）。结论FOLFIRI方案化疗联用贝伐珠单抗提高了晚期结直肠癌患者治疗的有效率和临床获益率,并延长了PFS,不良反应患者可以耐受。     

贝伐珠单抗联合FOLFIRI方案一线治疗转移性结直肠癌的临床研究

目的评价贝伐珠单抗联合FOLFIRI方案一线治疗转移性结直肠癌的疗效和安全性。方法将42例转移性结直肠癌患者随机分为FOLFIRI组和FOLFIRI+贝伐珠单抗组。FOLFIRI组(n=21)采用伊立替康(CPT-11,180 mg/m~2,d1)+甲酰四氢叶酸钙(CF,400 mg/m~2,d1)+氟尿嘧啶(5-FU,400 mg/m~2,静脉推注,d1;然后5-FU,2400 mg/m~2,以微量泵进行持续静脉滴注46小时)。FOLFIRI+贝伐珠单抗组(n=21)采用贝伐珠单抗(每2周5 mg/kg,d1)+FOLFIRI方案。2周为1个周期,3个周期后评价疗效。两组患者均持续治疗至病情进展或毒性不能耐受。结果 42例患者均可评价疗效和不良反应。FOLFIRI组和FOLFIRI+贝伐珠单抗组的治疗有效率分别为28.6%和61.9%,FOLFIRI+贝伐珠单抗组的有效率显著高于FOLFIRI组(P=0.03)。FOLFIRI+贝伐珠单抗组的临床获益率明显高于FOLFIRI组(90.5%vs 61.9%,P=0.03)。FOLFIRI组和FOLFIRI+贝伐珠单抗组中位无疾病进展时间(progression-free survival,PFS)分别为6.6个月和10.0个月(P=0.000)。两组的主要不良反应为迟发性腹泻和中性粒细胞减少,贝伐珠单抗组增加的不良反应主要有高血压(P=0.002)、出血(P=0.001)和蛋白尿(P=0.035)。结论 FOLFIRI方案化疗联用贝伐珠单抗提高了晚期结直肠癌患者治疗的有效率和临床获益率,并延长了PFS,不良反应患者可以耐受。     

贝伐珠单抗联合含铂化疗方案一线治疗晚期非鳞NSCLC疗效分析

目的观察贝伐珠单抗联合含铂化疗方案一线治疗晚期非鳞非小细胞肺癌的疗效和安全性。方法经病理证实的55例晚期非鳞非小细胞肺癌采用贝伐珠单抗联合化疗作为一线治疗。贝伐珠单抗按7.5 mg/kg剂量在化疗第1天给予,每21天重复,至不能耐受或疾病进展。联合的一线化疗方案包括：培美曲塞加铂类（顺铂、卡铂或奈达铂）（培美曲塞组,n=41）或紫杉类加卡铂（紫杉类组,n=14）。每治疗2周期进行CT或MRI检查评价疗效并记录不良反应。结果 55例患者中无完全缓解病例,部分缓解33例,疾病稳定20例,疾病进展2例。疾病总有效率60.0%（33/55）,疾病控制率96.4%（53/55）,中位PFS为7.2月（1.7-31.5月,95%CI：6.0～8.4）。紫杉类组的中位PFS有优于培美曲塞组的趋势（8.5月vs 6.5月）,但差异无统计学意义（P=0.058）。培美曲塞组中位治疗周期数少于紫杉类组（4周期vs 9周期,P=0.000）。以顺铂为基础化疗患者（n=21）的有效率高于以卡铂为基础化疗的患者（n=31）（81.0%vs 51.6%,χ2=4.65,P=0.031）。不良反应方面,有2例出现大咯血,1例出现3级高血压,1例出现亚急性多发性脑梗死而停药,其余不良反应均为1～2级,可耐受。贝伐珠单抗联合顺铂或卡铂组引起不良反应相似。结论贝伐珠单抗联合含铂化疗方案一线治疗晚期非鳞非小细胞肺癌患者耐受性较好。     

白蛋白结合型紫杉醇联合贝伐珠单抗治疗复发性卵巢癌的临床分析

目的:探讨白蛋白结合型紫杉醇联合贝伐珠单抗治疗复发性卵巢癌疗效、不良反应和生存情况。方法:选取经病理学诊断为卵巢上皮癌患者78例,既往使用过紫杉类、吉西他滨等药物治疗后进展,接受白蛋白结合型紫杉醇联合贝伐珠单抗方案治疗。具体方案:第1天接受白蛋白结合型紫杉醇260mg/m2、第2天接受贝伐珠单抗15mg/m2,21d为1个周期,每个周期评价不良反应,2个周期评价疗效。结果:78例患者均可进行疗效评价,无完全缓解病例,部分缓解9例,稳定42例,进展27例,有效率为11.5%（9/78）,临床获益率为65.4%(51/78)。主要不良反应为骨髓抑制、消化道反应、乏力、脱发、外周神经毒性、皮疹、高血压、肌肉酸痛,不良反应多为I级和II级毒性,患者对毒副作用均可耐受,未发生治疗相关性死亡。结论:白蛋白结合型紫杉醇联合贝伐珠单抗治疗复发性卵巢癌可获得较好的疗效,不良反应可以耐受。     

First-line bevacizumab plus taxane-based chemotherapy for locally recurrent or metastatic breast cancer: safety and efficacy in an open-label study in 2251 patients

BackgroundFirst-line bevacizumab combined with chemotherapy significantly improves efficacy versus chemotherapy alone in human epidermal growth factor receptor 2 (HER2)-negative locally recurrent or metastatic breast cancer (LR/mBC). This large, open-label study further assesses first-line bevacizumab with taxane-based chemotherapy in routine oncology practice.Patients and methodsPatients with HER2-negative LR/mBC, Eastern Cooperative Oncology Group (ECOG) performance status (PS) of zero to two and no prior chemotherapy for LR/mBC received bevacizumab 10 mg/kg every 2 weeks or 15 mg/kg every 3 weeks plus taxane-based chemotherapy (or other non-anthracycline chemotherapy) until disease progression, unacceptable toxicity or patient withdrawal. The primary end point was safety; time to progression (TtP) was a secondary end point.ResultsMedian follow-up in 2251 treated patients was 12.7 months. Median age was 53 years and 94% of patients had ECOG PS of zero or one. Bevacizumab was most commonly administered with single-agent paclitaxel (35%), single-agent docetaxel (33%) or taxane-based combination therapy (10%). The most frequent grade ≥3 adverse event (AE) was neutropenia (5.4%). Grade ≥3 AEs previously associated with bevacizumab included hypertension (4.4%), arterial/venous thromboembolism (3.2%), proteinuria (1.7%) and bleeding (1.4%). No new bevacizumab safety signals were observed. Median TtP was 9.5 months (95% confidence interval 9.1–9.9).ConclusionsThe study population in ATHENA was more representative of general oncology practice than populations enrolled into randomised trials, although there may have been some bias towards younger, fitter patients. The safety and efficacy of bevacizumab–taxane therapy in this large study were consistent with results from randomised first-line trials.     

First-line bevacizumab in combination with weekly paclitaxel for metastatic breast cancer: efficacy and safety results from a large, open-label, single-arm Japanese study

Despite extensive evaluation of first-line bevacizumab-containing therapy in randomized trials in locally recurrent/metastatic breast cancer (LR/mBC), data from Japanese populations are limited. We conducted a phase II study exclusively in Japanese patients to evaluate bevacizumab combined with weekly paclitaxel. Patients with HER2-negative measurable LR/mBC who had received no prior chemotherapy for LR/mBC received bevacizumab 10 mg/kg, days 1 and 15, in combination with paclitaxel 90 mg/m(2), days 1, 8, and 15, repeated every 4 weeks, until disease progression, unacceptable toxicity, or patient/physician decision. Co-primary endpoints of this single-arm open-label phase II study were progression-free survival (PFS) and safety. A total of 120 patients (median age 55 years) received study therapy. At the time of data cut-off, the median duration of therapy was 11.1 months (range 0.5-24.7 months). Median PFS was 12.9 months (95% CI: 11.1-18.2) according to Independent Review Committee assessment and 14.9 months by investigator assessment. Median PFS was 9.6 months in the subgroup of 38 patients with triple-negative LR/mBC. The overall response rate was 74% (95% CI: 64.5-81.2%). Median overall survival (OS) was 35.8 months (95% CI: 26.4-not estimated) and the 1-year OS rate was 88.9% (95% CI: 83.2-94.6). The regimen was well tolerated and the safety profile was generally consistent with previous reports of bevacizumab-paclitaxel combination therapy. Grade 3 hypertension was reported in 17% of patients. Grade 4 hypertension, grade 3/4 proteinuria, and gastrointestinal perforation were absent. There were no new bevacizumab safety signals. In 50 patients (42%), treatment was continued for ≥ 1 year. Conclusion: The high activity of first-line bevacizumab in combination with weekly paclitaxel observed in our study confirms the results of the E2100 trial. Our results suggest that the activity and tolerability of first-line bevacizumab-containing regimens demonstrated in E2100 can be reproduced in Japanese populations.     

Final overall survival results and effect of prolonged (≥ 1 year) first-line bevacizumab-containing therapy for metastatic breast cancer in the ATHENA trial

The ATHENA study expanded on the safety and efficacy data derived from first-line trials of bevacizumab combined with standard chemotherapy for locally recurrent/metastatic breast cancer (LR/mBC). In ATHENA, 2,264 patients received first-line bevacizumab-containing therapy in routine oncology practice. Overall survival (OS) data are now mature; additional analyses from this large data set can provide insights into treatment duration and the effect of prolonged bevacizumab exposure, where data are currently limited. Patients with HER2-negative LR/mBC received first-line bevacizumab with standard chemotherapy until disease progression, unacceptable toxicity, or physician/patient decision. We performed subgroup analyses on data from patients treated for ≥12 months and those who continued single-agent bevacizumab after stopping chemotherapy. After median follow-up of 20.1 months, median OS was 25.2 months (95% confidence interval [CI] 24.0–26.3 months) in the entire population. Median OS was 30.0 months (95% CI 28.5–32.7 months) in 1,205 patients who continued bevacizumab after discontinuation of chemotherapy and 18.4 months (95% CI 17.2–19.7 months) in 1,058 patients who discontinued bevacizumab before or at the same time as stopping chemotherapy. Bevacizumab treatment was continued for ≥12 months in 473 patients (21%). In most, bevacizumab was administered as monotherapy for extended periods after stopping chemotherapy. In the subgroup of patients treated for ≥12 months, the median time to onset of grade 3–5 adverse events was 5.0 months. There was no evidence that first onset of adverse events of special interest, except for proteinuria, was more common in later than earlier cycles. No relationship was detected between development of hypertension and OS. Findings from these analyses suggest that patients with LR/mBC can receive bevacizumab for prolonged periods without major toxicity or progression of disease. In the absence of progression, continuation of single-agent bevacizumab appears to be a reasonable approach, with minimal toxicity and the possibility of long-term disease control.     

FOLFOX4方案和ECF方案治疗晚期胃癌的比较

目的：比较FOLFOX4方案和ECF方案治疗晚期胃癌的临床疗效及不良反应。方法：将50例经病理确诊的晚期胃癌患者随机分为两组。治疗组25例，采用FOLFOX4方案化疗：草酸铂85mg／m^2，静脉滴注2h，d1；亚叶酸钙200mg／m^2，静脉滴注2h，d1、d2；氟尿嘧啶400mg／m^2，静脉推注，d1、d2，氟尿嘧啶600mg／m^2，持续静脉泵输注22h，d1、d2。每2周为1周期。对照组25例，采用ECF方案化疗：表柔比星50mg／m^2，静脉推注，d1；氟尿嘧啶400mg／m^2，静脉滴注，d1～d5；顺铂20mg／m^2，静脉滴注，d1～d3。每3周为1周期。对两组的缓解率、生活质量改善率、不良反应进行分析比较。结果：治疗组与对照组的缓解率分别为56％（14／25）和52％（13／25），无显著性差异（χ^2=0．73，P〉0．05）；生活质量改善率分别为76％（19／25）和48％（12／25），有显著性差异（χ^2=6．23，P〈0．05）；两组主要不良反应白细胞减少、腹泻、口腔炎、神经毒性和脱发等指标的差异具有显著性（P〈0．05）。结论：FOLFOX4方案和ECF方案治疗晚期胃癌近期疗效较好，不良反应较轻；在生活质量改善方面，FOLFOX4方案优于ECF方案。     

DF和DCF方案治疗晚期胃癌的临床对比研究

目的：比较DF（DOC＋5-FU＋CF）和DCF（DOC＋DDP＋5-FU＋CF）方案治疗晚期胃癌的近期疗效及不良反应。方法：将61例经病理确诊的晚期胃癌患者随机分为两组。A组28例,采用DF方案化疗：多西他赛（DOC）75 mg/m2,静脉滴注,第1天;亚叶酸钙（CF）200mg/m2静脉滴注,第1天,2小时后5-氟尿嘧啶（5-FU）500mg静脉推注,随后5-FU2500mg/m2持续120小时化疗泵静脉内注入,21天为1周期。B组33例,采用DCF方案化疗：顺铂（DDP）25mg/m2,第1-3天,多西他赛、亚叶酸钙、5-氟尿嘧啶用法同DF组,21天为1周期。对两组的近期疗效、疾病进展时间和不良反应进行比较。结果：A组和B组的客观有效率分别为53.6%（15/28）和51.5%（17/33）,无显著性差异（P=0.610）,中位疾病进展时间分别为5.6个月和5.3个月,亦无显著性差异（P=0.362）。主要不良反应白细胞减少和恶心、呕吐的差异具有显著性（P均〈0.05）。结论：DF和DCF方案治疗晚期胃癌有较好疗效,且疗效相似,在不良反应方面,DF方案优于DCF方案。     

双铂联合氟尿嘧啶二线治疗复发转移食管癌研究

[目的]观察双铂方案二线治疗复发转移食管癌的近期疗效及不良反应。[方法]30例一线化疗后复发转移食管癌患者,进行二线治疗,化疗方案：顺铂25mg/m^2d1,奈达铂25mg/m^2d2,3,氟尿嘧啶0.35g/m^2civ d1～7,3周重复。[结果 ]部分缓解（PR）11例,疾病稳定（SD）8例,疾病进展（PD）11例,有效率（RR）为36.7%,疾病控制率（DCR）为63.3%,中位达进展时间（TTP）为4.3个月（95%CI：1.1～10.5）,中位生存时间（MST）为8.9个月（95%CI：2.1～15.3）。主要不良反应为血液学毒性,Ⅲ～Ⅳ级白细胞减少的发生率分别为13.3%,Ⅲ级口腔炎的发生率为6.7%。[结论]双铂联合氟尿嘧啶二线治疗复发转移食管癌的近期疗效较好,不良反应可耐受。     

紫杉醇联合顺铂治疗晚期食管癌51例

[目的]观察紫杉醇（PTX）联合顺铂（DDP）组成的TP方案治疗晚期食管癌的近期疗效和毒副反应。[方法]51例晚期食管癌患者，给予TP方案化疗：P1X 175mg／m^2 ivgtt d1；DDP 40mg／m^2 ivgtt d1-3,21d为1个周期。[结果]51例患者均可评价疗效，总有效率37.3％，稳定率54．9％，临床获益率达92．2％。37例初治组有效率40．5％，其中CR2例，14例复治组有效率28．6％，CR1例。毒副反应主要为剂量限制性毒性，表现为Ⅲ～Ⅳ度骨髓抑制（17．6％）。[结论]TP方案治疗晚期食管癌有效率较高，毒副反应可耐受。