紫杉醇与顺铂同步化疗联合放疗治疗老年食管癌33例分析

[目的]探讨紫杉醇与顺铂同步化疗联合放疗治疗老年食管癌患者的疗效和安全性。[方法]33例局部晚期老年食管鳞癌患者，采用根治性同步放化疗，放疗剂量60Cy（分两阶段进行），放疗的第1d和第29d给予紫杉醇（135mg／m^2，d1）和顺铂（20mg／m^2，d1）化疗。[结果]81．81％的患者完成了治疗计划，24．24％的患者放疗总时间延长；Ⅲ级以上急性毒副反应主要为造血系统毒性（白细胞减少21.21％、血红蛋白减少3．03％、血小板减少12．12％），放射性食管炎（18．18％），肌肉酸痛（6．06％），放射性皮炎（6．06％），远期毒性反应主要为食管狭窄（15．15％）、放射性肺损伤（6．06％）；中位生存时间18．17个月，5年生存率、局控率、无瘤生存率分别为22．85％、30．90％和18．29％。[结论]紫杉醇与顺铂同步化疗联合放疔治疗老年性食管癌的毒副反应可耐受．值得临床推广应用。

An Analysis of Concurrent Chemoradiotherapy with Cisplatin and Paclitaxel Chemotherapy for 33 Cases with Esophageal Cancer in Elderly Patient

[ Purpose ] To evaluate the efficacy and feasibility of concurrent chemoradiotherapy with paclitaxel and cisplatin chemotherapy in elderly patients with esophageal carcinoma. [Methods] Thirty-three elderly patients with locally advanced esophageal carcinoma underwent concurrent chemoradiotherapy. The fraction dose of 2.0Gy daily was prescribed with a total dose of 60Gy for 6 weeks in 2 phases. Concurrent chemotherapy containing paclitaxel （135mg/m^2,d1） and cisplatin （20mg/m^2,d1） were administered on dl and d29 of the radiotherapy. [Results] Among the 33 patients, treatment plan completed in 81.81% and the course delayed in 24.24%. During the chemoradiotheapy, acute toxicities on grade 3 or more such as leucopenia, anemia, thrombocytopenia, esophagitis, sore muscle and radiodermatitis were 21.21%, 3.03%, 12.12%, 18.18%, 6.06% and 6.06%, respectively. Major late toxicities were esophageal stenosi （15.15%） and lung fibrosi （6.06%）. The median survival time was 18.17 months. The 5-year survival rate, local control and disease-free survival rate were 22.85%, 30.90% and 18.29%, respectively. [Conclusion] Chemotherapy of paclitaxel and cisplatin combined with radiation is worth while applied for elderly patients with esophageal carcinoma. The toxicities are well tolerable.