多西他赛或吉西他滨联合替吉奥二线治疗晚期食管鳞癌的临床疗效和安全性分析

目的 比较多西他赛或吉西他滨联合替吉奥二线治疗晚期食管鳞癌的临床疗效和安全性.方法 选取一线紫杉醇联合铂类化疗方案治疗失败或缓解后再进展的晚期食管鳞癌患者61例,根据二线化疗方案不同将患者分为多西他赛组和吉西他滨组,多西他赛组(n=31)给予多西他赛联合替吉奥治疗,吉西他滨组(n=30)给予吉西他滨联合替吉奥治疗.两组患者均每2个周期评价疗效,并对两组患者的疗效、不良反应发生情况、无进展生存情况进行比较.结果 多西他赛组和吉西他滨组患者的有效率(RR)分别为25.806%、16.667%,疾病控制率(DCR)分别为61.290%、56.667%,中位无进展生存期(PFS)分别为4.5个月、4.0个月,差异均无统计学意义(P>0.05).两组患者的主要不良反应均为血液学不良反应和消化道不良反应,经过对症治疗均可缓解,多西他赛组的中性粒细胞减少、血小板减少、乏力及皮疹的发生率低于吉西他滨组(P<0.05).结论 多西他赛或吉西他滨联合替吉奥药物作为二线化疗方案治疗晚期食管鳞癌疗效相当,但多西他赛相较吉西他滨可有效降低化疗不良反应发生率.

Analysis of the clinical efficacy and safety of docetaxel or gemcitabine combined with S-1 as second-line chemotherapy for advanced esophageal squamous cell cancer

Objective To compare the efficacy and safety of docetaxel or gemcitabine combined with S-1 as second-line chemotherapy for advanced esophageal squamous cell cancer. Method 61 cases of advanced esophageal squamous carcinoma with treatment failure or disease progression after response as a result of first-line paclitaxel plus platinum-based chemotherapy were included in the analysis, receiving docetaxel combined with S-1 (n=31), or gemcitabine com-bined with S-1 (n=30). RECIST was applied to evaluate the clinical efficacy in both groups every 2 cycles, and the over-all effect, incidence of adverse reactions, as well as progression-free survival (PFS) were compared. Result The re-sponse rates were 25.806% and 16.667% for patients treated with docetaxel and gemcitabine, with the disease control rates being 61.290%and 56.667%, and the median PFS were 4.5 months and 4.0 months, respectively, no significant dif-ferences were observed (P>0.05). The major adverse reactions in both groups were hematological toxicities and gastroin-testinal reactions, which were reversible after symptomatic treatment. But the docetaxel group had significantly lower in-cidence of neutropenia, thrombocytopenia, fatigue and rash than gemcitabine group (P<0.05). Conclusion The effects of docetaxel or gemcitabine combined with S-1 are similar in the treatment of advanced esophageal squamous cell cancer, while less adverse reactions occur with docetaxel compared with gemcitabine.