洛铂联合紫杉醇同步放化疗对中晚期食管癌的近期疗效

 目的　观察洛铂联合紫杉醇同步放化疗对中晚期食管癌的近期疗效及患者不良反应。方法　回顾性分析2010年4月至2011年5月收治的首程行同步放化疗的中晚期食管鳞状细胞癌患者26例，化疗方案：紫杉醇135 mg／m2，第1天；洛铂35 mg／m2，第2天，3周重复；放疗于第1周期化疗结束后第2天进行，中位总剂量60 Gy，30次，共6周。结果　全组共化疗52个周期，平均每例2个周期。近期疗效：完全缓解（CR）7例（26.9 %），部分缓解（PR）17例（65.4 %），疾病稳定（SD）2例（7.7 %），总有效（CR+PR）率为92.3 %。患者不良反应：骨髓抑制方面，白细胞下降Ⅰ～Ⅱ度46.1 %（12例），Ⅲ～Ⅳ度46.1 %（12例），血小板下降Ⅰ～Ⅱ度30.8 %（8例），Ⅲ～Ⅳ度7.7 %（2例），血红蛋白下降Ⅰ～Ⅱ度42.3 %（11例），Ⅲ度15.4 %（4例）；脱发84.6 %（22例）；肌肉或关节痛69.2 %（18例）；胃肠道反应Ⅰ～Ⅱ度11.5 %（3例）；放射性食管炎88.5 %（23例）；放射性气管炎19.2 %（5例）。结论　洛铂联合紫杉醇同步放化疗对中晚期食管癌的近期疗效好，患者不良反应能够耐受，值得临床进一步研究。

Recent results of concurrent chemoradiotherapy with lobaplatin and paclitaxel in advanced esophageal carcinoma

Objective To investigate recent treatment result and the toxic responses of chemoradiotherapy with lobaplatin and paclitaxel in advanced esophageal carcinoma. Methods From April 2010 to May 2011, 26 initial treatment patients with advanced esophageal carcinoma were enrolled. The chemotherapy consisted of paclitaxel （135 mg/m2） on day I and lobaplatin （35 mg/m2） on day 2, and one cycle continued 21 days. Radiotherapy started on the second day after the fist cycle of chemotherapy. The median total dose was 60 Gy （2 Gy/Fraction, 30 fractions, completed in 6 weeks）. Results There were 52 cycles in all and mean 2 cycles per patient. CR occurred in 7 patients （26.9 %）, PR in 17 patients （65.4 %） and SD in 2 patients （7.7 %）. The total effective rate was 92.3 % （CR＋PR）. The toxic responses mainly represented as following, myelotoxicity principally showed leucopenia at grade Ⅰ～Ⅱ occurred 46.1% （12/26） and at grade Ⅲ～Ⅳ 46.1% （12/26）, thrombopenia at grade Ⅰ～Ⅱ occurred 30.8 % （8/26） and at grade Ⅲ～Ⅳ 7.7 % （2/26）, hypohemoglobinemia at grade Ⅰ～Ⅱ occurred 42.3 % （11/26） and at grade Ⅲ 15.4 % （4/26）. Baldness occurred 84.6 % （22/26）. Pain of muscles or arthralgia occurred 69.2 % （18/26）. Responses of gastrointestinal tract at grade Ⅰ～Ⅱ occurred 11.5 % （3/26）. Radiation induced esophagitis occurred 88.5 % （23/26） and traeheitis 19.2 % （5/26）. Conclusion The toxic responses of concurrent chemoradiaotherapy with lobaplatin and paclitaxel in advanced esophageal carcinoma are tolerant, and the recent treatment result is good. Further study is needed.