基于不同肿瘤标志物的表达水平评估多西他赛联合顺铂治疗食管癌的化疗效果

The Evaluation of Chemotherapy Effectiveness in the Treatment of Esophageal Cancer Used Docetaxel with Cisplatin Based on the Expression of Different Tumor Markers

目的观察多西他赛联合顺铂化疗治疗食管癌的效果及部分肿瘤标志物的水平变化情况。方法对本院收治的50例食管癌患者给予TP方案化疗,静脉滴入多西他赛75mg/m2,d1;静脉滴入顺铂80mg/m2,d1～d3,21d重复,所有患者进行3个周期化疗,监测化疗前后患者4项肿瘤标志物含量CEA、CA19-9、SCC、CA724水平,观察比较临床患者近期疗效、毒副反应、1年生存率、治疗前后不同肿瘤标记物水平变化情况。结果总有效率(CR+PR)为78%,1年生存率为52%,化疗后患者的临床分期明显降低;主要毒副反应是骨髓抑制I,级白细胞下降为13例(26%),Ⅱ级21例(42%),脱发46例(92%),肌肉或关节痛29例(58%),恶心纳差27例(54%),疲劳16例(32%),均经对症处理后得到缓解,化疗不良反应可以耐受,化疗后患者血清CEA、CA19-9、CA724、SCC明显低于化疗前。结论多西他赛加顺铂化疗配合放疗治疗食管癌临床疗效确切,降低病情分期,毒副反应轻,患者能够耐受,近期疗效可靠,值得临床进一步研究,建议引入肿瘤标志物的疗效评估标准。

Objective To observe the chemotherapy effect in the treatment of esophageal cance used Docetaxel with cisplatin, and the level of the tumor marker. Methods All 50 esophageal cancer patients were given chemotherapy TP, intravenous infusion of docetaxel 75mg/m2, dl. intravenous infusion of cisplatin 80mg/m2, dl -d3, 21d repeat, 3 courses of chemotherapy, four levels of tumor markers CEA, CA19-9, SCC, CA724 levels were monited. The recent clinical efficacy, toxicity, 1-year survival rate, tumor marker level changes were observed. Results The total effective rate （ CR ＋ PR ） was 78%, 1-year survival rate was 52%, the clinical stage reduced after chemotherapy.Main toxicity was myelosuppression, I grade leukopenia 13 cases （26%）, H 21 patients （42%）, alopecia in 46 cases （ 92% ）, muscle or joint pain in 29 cases （ 58% ）, nausea and anorexia 27 patients （ 54% ）, fatigue in 16 patients （ 32% ）, were eased after symptomatic treatment, chemotherapy side effects can be tolerated after chemotherapy , the CEA, CA19-9, CA724, SCC was significantly lower than before chemotherapy. Conclusion The Chemotherapy contained Docetaxel with cisplatin have clinical efficacy, lower disease stage, light toxicity, reliable short-term effect, in treatment of esophageal cancer, the patient can tolerate, worthy of further clinical studies, and recommended the introduction of tumor markers evaluation criteria assessing the effect.