拓僖联合顺铂治疗晚期食管鳞癌的临床观察

Clinical study of lyophilized 10-hydroxycamptothecin combined with cisplatin in the treatment of esophageal cancer

目的观察拓僖(HCPT)联合顺铂(DDP)治疗晚期食管癌的近期疗效和毒副反应.方法 30例晚期食管癌患者应用HCPT 4.68～7.04 mg/m2(中位剂量为5.6 mg/m2),静脉滴注,连续3 d;DDP 58.5～100 mg/m2(中位剂量为70 mg/m2),第1天,静脉滴注;21 d为一周期,至少治疗2个周期.结果全组共完成化疗101个周期,中位化疗周期4个周期.28例可评价患者的有效率为42.9%(12/28),CR 1例,PR 11例,SD 11例,PD 5例.主要毒副反应为骨髓抑制,其他毒副反应包括恶心、呕吐,腹泻,一过性肝、肾功能轻度损害.无心、肺毒副反应发生.Ⅲ/Ⅳ度白细胞下降、恶心呕吐、血小板下降、腹泻发生率分别为28.7 %、21.8%、13.9%和2.0%.结论拓僖联合顺铂治疗食管癌疗效好,毒副反应可以耐受.

Objective To investigate the efficacy, toxicity of combination regimen of TUOXI （ 10- hydroxycamptothecin, HCPT） and cisplatin in treatment of advanced and recurrent esophageal cancer. Methods Thirty patients with advanced esophageal cancer were enrolled in this study. HCPT was give at the dosage of 4.68 -7.04 mg/（ m^2· d） （ median dosage 5.6 mg/（ m^2· d） for 3 consecutive days. Cisplatin was given at the dosage of 58.8-100 mg/（ m^2· d）（ median dosage 70 mg/m^2） on dl. The treatment cycle was repeated every 3 weeks,with at least two cycles. Results A total of 101 cycles were given and the median number of treatment cycles was four. Twenty-eight patients could be evaluated for effectiveness. The objec- tive response rate for the whole group was 42.9% （ 12/28 ）. Myelosuppression was the dose-limiting toxicity and other adverse reactions included nausea/vomiting, diarrhea, transient hepatic and renal function disorder. The incidence of grade-Ⅲ/Ⅳ adverse events were 28.7% , 21.8% , 13.9% , 2.0% for leucopenia, nausea/vomiting, thrombocytopenia, and diarrhea, respectively. No pulmonary, and cardiac toxicity was found. Conclusion TUOXI and cisplatin represent a well-tolerated active palliative regimen for patients with recurrent/metastasis esophageal cancer.