胸中下段局部晚期食管鳞癌术前多西他赛联合奈达铂新辅助治疗的初步疗效评价

目的 评价多西他赛＋奈达铂方案新辅助化疗并手术治疗胸中下段局部晚期食管鳞癌的近、远期疗效和安全性.方法 2009年1月～2012年1月64例经病理学证实的胸中下段局部晚期食管鳞癌,采用多西他赛＋奈达铂方案新辅助化疗,多西他赛75mg/m2,d1,奈达铂80mg/m2,d2,每3周重复,应用两周期,化疗结束后3周进行手术评估并行手术治疗.结果 新辅助化疗的不良反应多为1～2级反应,其中3～4度血液学毒性累计：白细胞计数减少15.6％（10/64）,血小板计数减少3.1％（2/64）.化疗有效率为58.3％ （35/64）,手术切除率为96.7％（60/64）,完全性切除率为91.7％（56/60）,无围术期死亡,术后并发症发生率低.定期随访,随访率为100％,1年、2年的生存率、无局部、区域复发生存率以及无转移生存率分别为86.7％（52/60）和71.7（43/60）,73.3％（44/60）和65.0％ （39/60）,88.3％ （55/60）和78.3％（47/60）.结论 多西他赛联合奈达铂新辅助治疗胸中下段局部晚期食管鳞癌近期疗效高,两年生存率较高,不良反应可耐受,安全性好.

Effect Evaluation of Neoadjuvant Chemotherapy with Docetaxel and Nedaplatin for Patients with Middle or Lower Thoracic Locally Advanced Esophageal Squamous Cell Carcinoma

Objective To investigate the efficacy and side effect of neoadjuvant chemotherapy with docetaxel and nedaplatin for patients with upper or middle thoracic locally advanced esophageal squamous cell carcinoma.Methods From January 2009 to January 2012,64 patients with locally advanced locally advanced esophageal squamous cell carcinoma received docetaxel and nedaplatin neoadjuvant chemotherapy.All patients were taken docetaxel 75mg/m2 on day 1,nedaplatin 80mg/m2 on day2.The treatment schedule was recycled every 3 weeks.After 2 cycles,the patients with possibility of surgical resection received surgery.Results The overall leukopenia and thrombocytopenia declined in grade 3 and 4 with 15.6% and 3.1% and the overall response rate was 46.1%.Sixty patients underwent resection in 64 cases and 56 patients underwent complete resection.No Perioperative mortality and postoperative complications was low.The follow-up rate was 100% by February 2014.The 1-and 2-year overall survival rate was 86.7% and 71.7%,respectively,while locoregional relapse-free survival were 73.3% and 65.0%,respectively.Meanwhile,the 1-and 2-year distant metastasis-free survival rates were 88.3% and 78.3%,respectively.Conclusion Neoadjuvant chemotherapy with docetaxel and nedaplatin for patients with upper or middle thoracic locally advanced esophageal squamous cell carcinoma can achieve fine result in clinical response and in 2-year local control,so as to survival rate.The side effect is clinically acceptable.