多西他赛联合顺铂治疗同步放疗中晚期食管癌的疗效观察

Clinical observation of docetaxel combined with cisplatin in treatment of advanced esophageal cancer with synchronous radiotherapy

目的探讨多西他赛联合顺铂治疗同步放疗中晚期食管癌的临床疗效和安全性。方法选取2009年3月—2011年3月上海市闵行区中心医院收治的中晚期食管癌患者112例,随机分为对照组（56例）和治疗组（56例）。两组患者均行放射治疗,对照组在放疗基础上静脉滴注顺铂注射液25 mg/m^2,1～3 d;静脉滴注氟尿嘧啶注射液500 mg/m^2,1～5 d。治疗组静脉滴注多西他赛注射液20 mg/m^2,1～3 d;静脉滴注顺铂注射液25 mg/m^2,1～3 d。两种方案均自放疗第1天开始,连续治疗21 d为1个疗程。治疗2个疗程后评价近期临床疗效,同时随访24～48个月,计算患者生存率和无进展生存率。结果治疗组和对照组的有效率分别为91.07%、80.36%,两组有效率比较差异有统计学意义（P〈0.01）。治疗组2、3、4年生存率明显高于对照组（P〈0.05）。治疗组Ⅲ～Ⅳ度恶心、呕吐、放射性食管炎、口腔炎的发生例数明显低于对照组,两组比较差异有统计学意义（P〈0.05）。结论多西他赛联合顺铂治疗同步放疗中晚期食管癌具有较好的临床疗效,对远期生存率也具有较好的效果,值得临床应用。

Objective To explore the clinical effect and safety of docetaxel combined with cisplatin in treatment of advanced esophageal cancer with synchronous radiotherapy. Methods Patients with advanced esophageal cancer who came to the Central Hospital of Minhang District in Shanghai from March 2009 to March 2011（112 cases） were randomly divided into control（56 cases） and treatment（56 cases） groups. Patients in two groups were given radiotherapy. The patients in the control group were iv administered with Cisplatin Injection（25 mg/m^2） for 1 — 3 d and Fluorouracil Injection（500 mg/m^2） for 1 — 5 d on the basis of radiotherapy. The patients in the control group were iv administered with Docetaxel Injection（20 mg/m^2） for 1 — 3 d and Cisplatin Injection（25 mg/m^2） for 1 — 3 d. Two treatment options started since the first day of radiotherapy, and continuous treatment of 21 d was as one course. Short-term clinical effect was evaluated, while followed up for 24 — 48 months, and the survival rate and progression-free survival rate were calculated. Results The efficacies in the treatment and control groups were 91.07% and 80.36%, respectively, and there were differences between the two groups（P〈0.01）. Survival rates of 2, 3, 4 years in the treatment group were obviously higher than those of the control group（P〈0.05）. The occurrence of Ⅲ- Ⅳ nausea, vomiting, radioactive esophagitis, and stomatitis in the treatment group was significantly lower than that in the control group, and there were differences between the two groups（P〈0.05）. Conclusion Docetaxel combined with cisplatin has good clinical effect in treatment of advanced esophageal cancer with synchronous radiotherapy, and also has a good effect for long-term survival, which is worthy of clinical application.