多西他赛联合伊立替康治疗晚期食管癌的疗效观察

The Therapeutic Effects of Docetaxel-irinotecan Combination on Advanced Esophageal Cancer

目的:观察多西他赛联合伊立替康治疗晚期食管癌的近期疗效和不良反应。方法:化疗方案:多西他赛35mg/m2,静脉滴注1h,d1,d8;伊立替康50mg/m2,静脉滴注30min,d1,d8。21d为一个周期,连续治疗三个周期后评定疗效。结果:全组病例45例,初次化疗29例,其中CR 1例(3.45%),PR 8例(27.59%),有效率31.04%;化疗暴露16例,其中CR 1例,PR 2例。中位进展期初次化疗患者为4个月,化疗暴露患者为3.6个月;中位生存期初次化疗患者为9个月,化疗暴露患者为11.5个月。主要毒副反应为腹泻、中性粒细胞减少和血糖升高,无不良反应致死事件。结论:多西他赛联合伊立替康治疗晚期食管癌临床疗效较好,毒副反应较轻,患者能耐受,值得进一步推广。

Objective：To evaluate the therapeutic response and toxic effects of docetaxel–irinotecan combination treatment of advanced esophageal cancer.Methods：Patients who had unresectable/metastatic squamous cell carcinoma or adenocarcinoma of the esophagus were treated with 35mg/m2 docetaxel infused over 1 hour on day 1 and 8 of a 21-day circle.Immediately following docetaxel administration（days 1 and 8）,irinotecan 50 mg/m2 was infused over 30min.Tumor assessment was carried out every three cycles.Results：Total 45 eligible patients were enrolled,including 29 chemotherapy-naive（CN） and 16 chemotherapy-exposed（CE）.Among 29 CN patients,there were one（3.45%） with a complete response（CR） and eight（27.59%） with a partial response（PR）.The total effective rate was 31.04%.There were one CR and two PRs among the patients with CE.Median time to progression for CN patients was 4.0 months and for CE patients 3.6 months.Median survival time for CN patients was 9.0 months and for CE patients 11.5 months.Principal toxic effects were diarrhea,neutropenia and hyperglycemia.There were no toxic deaths.Conclusion：The combined chemotherapy of docetaxel-irinotecan is effective and promising in the treatment of advanced esophageal cancer,and the adverse reactions are tolerable.