紫杉醇联合奈达铂治疗晚期食管癌的临床研究

Effect of paclitaxel combined with nedaplatin on treatment of patients with advanced esophageal cancer

目的探讨紫杉醇联合奈达铂治疗晚期食管癌的安全性和有效性。方法将48例晚期食管癌患者随机分为2组，分别应用紫杉醇联合奈达铂方案及紫杉醇联合顺铂方案行全身静脉化疗。紫杉醇联合奈达铂组：紫杉醇130mg／m2，静脉滴注，d1、d8；奈达铂80mg／m2，静脉滴注，dl。紫杉醇联合顺铂组：紫杉醇130mg／m2，静脉滴注，dl、d8；顺铂80mg／m2，静脉冲入，d1。2组均每3周为1个化疗周期。疗程结束后，观察2组的近期疗效、生存期及不良反应发生情况。结果紫杉醇联合奈达铂组RR略高于紫杉醇联合顺铂组，但差异无统计学意义；紫杉醇联合奈达铂组9个月生存率显著高于紫杉醇联合顺铂组，差异有统计学意义，且其6、12、18个月的生存率均略高于紫杉醇联合顺铂组。2组主要不良反应均为骨髓抑制、消化道反应和脱发，以Ⅰ～Ⅲ度为主，且不良反应发生率比较，差异无统计学意义。结论对于无化疗禁忌证的晚期食管癌患者，应用紫杉醇联合奈达铂方案治疗疗效确切，可有效改善患者生活质量，延长生命，具有一定临床研究价值。

Objective To explore the safety and efficacy of paclitaxel combined with nedaplatin in the treatment of patients with advanced esophageal cancer. Methods 48 patients with advanced esophageal cancer were randomly divided into two groups, and they were treated with paclitaxel combined with nedaplatin or cisplatin respectively. Paclitaxel combined with nedaplatin group： 130 mg/m2 paclitaxel, intravenous drip on dl and d8; 80 mg/m2 nedaplatin, intravenous drip on dl. Paclitaxel combined with cisplatin group： paclitaxel group： 130 mg/m2 paclitaxel, intravenous drip on dl and d8; 80 mg/m2 cisplatin, intravenous injection on dl. 3 weeks were considered as a cycle of chemotherapy in both groups. Shortterm efficacy, survival time and adverse reactions were observed after treatment in both groups. Results RR in paclitaxel combined with nedaplatin group was slightly higher than paclitaxel combined with nedaplatin group. Survival rate within 9 months in paclitaxel combined with nedaplatin group was significantly higher than paclitaxel combined with nedaplatin group, and survival rates within 6, 12 and 18 months were slightly higher than paclitaxel combined with nedaplatin group. The main adverse reactions in both groups were bone marrow suppression, gastrointestinal reactions and alopecia mainly at grades Ⅰ - Ⅲ. Conclusion For advanced esophageal cancer patients without chemotherapy contraindications, the regimen of paelitaxel combined with nedaplatin can effectively improve the quality of life, prolong the life and improve clinical efficacy.