每周一次多西他赛同步放射治疗食管癌临床疗效观察

Clinical Observation of the Effect of Weekly Docetaxel with Synchronous Radiotherapy on Patients with Esophageal Cancer

目的:探讨每周一次的多西他赛(艾素)同步放射治疗不能手术食管癌的临床疗效。方法:于3年间收治88例不能手术的食管癌患者。化疗:多西他赛20mg/次,1次/周,总量为120-140mg/6-7次,与放疗同步进行;放疗为常规分割放射治疗,总剂量为60-70Gy/30-35F,治疗同时给予一定的对症支持,如G-CSF等。放疗前及放疗后复查上消化道造影、胸部CT、腹部B超等检查,以评价疗效。统计学处理采用SPSS11.5软件包进行分析,Kaplan-Meier统计生存率,Cox用于多因素分析。结果:临床疗效显示:CR29/88(33.0%),PR36/88(41.0%),有效率(CR+PR)74.0%;为1、2、3年生存率分别为89.8±3.7%、72.6±7.3%、38.7±13.6%(95%可信区间)。单因素分析示:病变的部位与生存无关(P=0.71;Cox多因素分析示:性别、年龄、组织学类型及病变部位均不是判断预后的独立因素。结论:每周一次的多西他赛同步放射治疗食管癌疗效较好,不良反应可以耐受。

Objective： To investigate the clinical effects of weekly Docetaxel with synchronous radiotherapy in patients with inoperable esophageal cancer. Methods： Eighty-eight patients with esophageal cancer were enrolled into this study over the past three years. The chemotherapeutic regimen included 20 mg of Docetaxel with weekly intravenous drip infusions. Synchronous radiotherapy was conducted. A dose of 60-70 Gy was delivered in 30 to 35 fractions over 6 to 7 weeks. Some related drugs were administered during the treatment. Examination using upper digestive tract radiograph, chest CT and upper abdomen supersonic echo-sounder were performed before and after the treatment. The significance of prognostic variables in the survival expectancy was evaluated with Kaplan-Meier survival analysis and the Cox stepwise regression model. Results： Complete response （CR） was found in 29 of 88 cases （33.0%） and partial response （PR） occurred in 36 cases （41.0%）, providing an overall response rate （CR＋PR） of 74.4%. The 1-, 2-, and 3-year survival rates were 89.8±3.7% [95% confidence interval （CI）], 72.6±7.3% and 38.7±3.6%, respectively. The location of the lesion had no significant effect on the survival （P=0.71）. Multivariate analysis showed that the sex, age, location of the lesion and histology were not significant prognostic factors. Conclusion： Weekly docetaxel concurrent with radiotherapy in patients with esophageal cancer is a feasible regimen with tolerable adverse effects.