吉西他滨联合奥沙利铂与多西他赛联合奥沙利铂治疗晚期食管鳞癌的临床观察

Clinical observation of gemcitabine combined with oxaliplatin compared with docetaxel combined with oxaliplatin in the treatment of patients with advanced esophageal cancer

目的:观察吉西他滨联合奥沙利铂及多西他赛联合奥沙利铂治疗晚期食管癌的疗效和毒副反应。方法:68例晚期食管癌患者均接受化疗,随机分为两组,每组34例患者:吉西他滨1000mg/m2,d1,8,静脉滴注30min;多西他赛75mg/m2,d1,奥沙利铂85mg/m2,d1。每3周为1个周期,2个周期后评价疗效及毒副反应。结果:两组没有观察到完全缓解病例。吉西他滨组:PR 19例,SD 9例,PD 6例,总有效率为55.9%,临床获益率82.4%,中位疾病进展时间6.1个月;多西他赛组:PR 16例,SD 11例,PD 7例,总有效率为47.1%,临床获益率79.4%,中位疾病进展时间5.1个月。两组有效率(55.9%vs 47.1%,P=0.47)、临床获益率(82.4%vs79.4%,P=0.38)及中位无进展生存时间(6.1月vs 5.1月,P=0.524)均无明显差异。主要毒副反应为血液学毒性和消化道反应,两组Ⅲ-Ⅳ度恶心呕吐发生率分别为14.7%和38.2%(P=0.028),Ⅲ-Ⅳ度白细胞减少分别为11.8%和47.1%(P=0.001),Ⅲ-Ⅳ度血小板减少分别为32.4%和8.8%(P=0.016),肌肉酸痛发生率分别为8.8%和32.4%(P=0.016),末梢神经麻木分别为11.8%和35.3%(P=0.022)。结论:吉西他滨联合奥沙利铂及多西他赛联合奥沙利铂治疗晚期食管癌近期疗效相近,毒副反应均可耐受。

Objective：To observe the effect and toxicities of gemcitabine combined with oxaliplatin （GP） and do- cetaxd combined with oxaliplatin （DP） in the treatment of patients with advanced esophageal cancer. Methods：Sixty - eight patients with advanced esophageal cancer were divided into two groups 34 cases in each group. One group re- ceived chemotherapy of gemcitabine combined with oxaliplatin,the other group received chemotherapy docetaxel con〉 bined with oxaliplatin. Gelncitabine 1000mg/m2,intravenous infusion for 30 min, d1,8 ; oxaliplatin 85mg/m2 , intrave- nous infusion d1 docetaxel,75mg/m2, repeated every 3 weeks. The effect and toxicities were evaluated after 2 cycles. Results：CR was not observed in two groups, in gemictabine group,PR was observed in 19 cases,SD in 9 cases,PD in 6 cases, disease control rate （DCR） reached 82.4%, objective remission rate （ORR） reached 55.9% ,the median time to progression was 6.1 months, in docetaxel group, PR was observed in 14 cases,SD in 11 cases, PD in 7 cases, disease control rate （DCR） was 79.4% , objective remission rate （ORR） 47.1%. The median time to progression was 5.1 months. There was no significant difference in GP group and DP group, disease control rate （82.4% vs 79.4% ,P=0.38） , objective remission rate （55.9% vs 47.1% ,P=0.47 ）, the median time to progression （6.1 months vs 5.1 months,P=0. 524）. The main toxicities were hematological toxieities and digestive reactions in two group. The grade Ⅲ/Ⅳ toxitices in GP group and DP group included nausea and vomiting （14.7% vs 38.2% ,P=0.028） ,granulocytopenia （11.8% vs 47.1% ,P=0.001） ,thrombocytopenia （32.4% vs 8.8% ,P=0.016） ,myal- gia （8.8% vs 32.4% ,P=0.016） ,and peripheral nerve numbness （11.8% vs 35.3% ,P=0. 022）. Condusion： There is no significant difference in gemcitabine combined oxaliplatin and docetaxel combined with oxaliplatin in the treatment of advanced esophageal cancer,and the toxicities cart be tolerated.