去甲斑蝥酸钠联合奥沙利铂和长春瑞滨治疗复发食管癌的近期疗效

Effect of Disodium norcanthandate combined with Oxaliplatin and Vinorelbine in treatment of recurred esophageal cancer

目的探讨去甲斑蝥酸钠联合奥沙利铂和长春瑞滨治疗复发食管癌的疗效与不良反应。方法选择38例经病理组织学和影像学证实的食管癌放化疗后复发转移的患者入组。静滴奥沙利铂130 mg/m^2,第1天;静滴长春瑞滨25 mg/m^2,第1、8天;静滴去甲斑蝥酸钠20 mg,每日1次;每21 d重复为一周期,至少应用2周期。结果 36例可评价病例,完全缓解3例(8.3%),部分缓解20例(55.6%),稳定9例(25.0%),进展4例(11.1%)。客观总有效率63.9%,中位缓解期4.6个月,中位疾病无进展时间(TTP)4.2个月,中位生存期6.3个月。在缓解症状、改善生存质量和提高KPS评分等方面都取得较好疗效。主要不良反应有骨髓抑制、消化道反应、外周神经毒性、静脉炎等。无治疗相关死亡者。结论去甲班蝥酸钠联合奥沙利铂和长春瑞滨治疗复发食管癌疗效较好,缓解率较高,不良反应能耐受,值得临床进一步研究。

Objective To evaluate the therapeutic effect and safety of Disodium norcantharidate combined with Oxaliplatin and Vinorelbine in treatment of recurred esophageal cancer. Methods 38 patients with recurred esophageal cancer diagnosed by histopathology were observed. Oxaliplatin was used by 130 mg/m^2 on day 1 ,Vinorelbine was used by25 mg/m^2 on day 1 ,8 ,with 21 days as a cycle. All patients were given Disodium norcantharidate 20 mg/d during the cycle and treated at least two cycles. Results Of 36 evaluated patients, three cases achieved complete remission（CR） and 20 achieved partial remission（PR） ,with an overall response rate of 63.9%. Median duration of remission was 4.6 months. Median time to pro- gression（ TrP）was 4.2 months. Median duration of survival was 6.3 months. The major toxicity included bone marrow suppression,alimentary canal reaction, peripheral nerve toxicity and phlebitis. Conclusion Disodium noreantharidate combined with 0xaliplatin and Vinorelbine is effective in treating the metastasis of recurred esophageal cancer patients with tolerable side reactions. It is worth studing in the future.