TP方案治疗难治性晚期食管鳞癌的临床观察

Clinical observation of TP regiment for treating refractory and terminal squamous cancer of the esophagus

目的观察国产紫杉醇(TAX)联合顺铂(PDD)组成的TP方案治疗难治性晚期食管癌的疗效及其不良反应.方法64例经PF方案化疗2周期后无效的难治性Ⅳ期食管鳞癌患者,应用TP方案化疗,即紫杉醇175 mg/m2,静脉恒速滴注3 h,d1;顺铂30 mg/d,静脉滴注,避光,d2～6;28 d为1个周期,连用3个周期后评价近期疗效及不良反应.结果全组64例患者共完成TP方案化疗192周期,均可评价疗效,共获得CR 9例、PR 29例、SD 12例、PD 14例,客观有效率为59.4%,中位缓解期为4.8个月,中位TTP为4.4个月,中位生存期为9.8个月(4～28个月).主要不良反应为骨髓抑制.结论TP方案治疗难治性晚期食管鳞癌近期疗效肯定,不良反应可以耐受,值得临床进一步研究.

Objective To evaluate the therapeutic efficacy and adverse effects of TP regimen consisting of taxol (TAX) and cisplatin (DDP) for treating refractory and terminal squamous cancer of the esophagus. Methods Totally 64 patients with stage IV squamous cancer of the esophagus, who failed to respond to a tow-course regiment, were treated with TP regimen with intravenous infusion of TAX 175 mg/m2 on day 1 and DDP 30 mg/d on days 2-6. After 3 consecutive treatment course, each for 28 days, evaluation of the short-term efficacy and adverse effects was carried out. Results All the 64 patients completed altogether 192 treatment courses of TP regiment, resulting in a total response rate of 59.4% including 9 patients with complete remission (CR) and 29 with partial remission (PR). Stabilization (SD) was achieved in 12 patients while 14 failed to respond favorably and had further progression (PD) of the disease. The median remission duration was 4.8 months, median TTP 4.4 months and median survival of 9.8 months (4-28 months). The main adverse effect of the regimen was bone marrow depression. Conclusion TP regimen for treating refractory and terminal squamous cancer of the esophagus is clinically effective and well tolerated.