紫杉醇与顺铂联合治疗晚期食道癌的临床疗效观察及安全性评估

目的探讨紫杉醇联合顺铂治疗晚期食道癌(advanc edesophageal cancer,AEC)的临床疗效及安全性。方法选择我院2007年9月～2011年2月收治并诊断为晚期食道癌患者160例,随机分为观察组和对照组,每组80例。观察组患者采用紫杉醇联合顺铂化疗方案治疗,TAX170mg.m-2d1+DDP30mg.m-2d1～d3,静脉滴注;对照组采用顺铂联合氟尿嘧啶方案,DDP30mg.m-2d1～d3+5-FU0.5g.m-2d1～d5。化疗结束后,评定治疗效果,并按照Kamofsky分级标准评价患者生活质量的改善情况。结果观察组治疗有效率为60.0%,明显高于对照组(P<0.05);平均生存时间为9.4±5.1个月,明显长于对照组(P<0.05);主要毒副作用为骨髓抑制和消化道反应,其发生率与对照组相比显著降低。化疗结束后,观察组患者生活质量改善的总体有效率78.8%,明显高于对照组(P<0.05)。结论紫杉醇与顺铂联合治疗AEC不仅临床疗效显著优于顺铂联合氟尿嘧啶,且不良反应小,并明显改善患者的生活质量。

Therapeutic Effects and Safety Evaluation of Treatment of Cisplatin Combined with Paclitaxel on Advanced Esophageal Cancer

Objective To investigate the therapeutic effects and safety evaluation of the treatment of Cisplatin combined with paclitaxel on advanced esophageal cancer(AEC).Methods From September 2007 to April 2010,160 patients with advanced esophageal cancer were collected and randomly divided into observation group and control group,80 patients in each group.Patients in the observation group were treated by cisplatin in combination with paclitaxel chemotherapy,TAX 170 mg·m-2 d1 + DDP 30 mg·m-2 d1～d3,IVGTT,while patients in the control group were treated by cisplatin and fluorouracil scheme,DDP 30 mg·m-2 d1～d3 + 5-FU 0.5 g·m-2 d1～d5.After chemotherapy,the therapeutic effect was analyzed and improvement of quality of life was evaluated according to Kamofsky Grading Score.Results The effective rate of observation group was 60.0%,which was significantly higher than that of control group(P<0.05).The average survival time was 9.4±5.1 months in observation group,which was significantly longer than control group(P<0.05).The effective rate of improvement of quality of life was 78.8%,which was also significantly higher than control group(P<0.05).The adverse effects such as gastrointestinal reaction,myelosuppression,allergic reactions,cardiotoxicity,joint sore and alopecia were all observed in both groups,but the overall incidence was lower in observation group than control group(P<0.05).Conclusion The treatment of cisplatin combined with paclitaxel had much better therapeutic effects and lower incidence rate of adverse effects on advanced esophageal cancer than treatment of cisplatin and fluorouracil.In addition,treatment of cisplatin and paclitaxel was able to improve the quality of life of patients with advanced esophageal cancer.