奈达铂或顺铂联合紫杉醇治疗晚期食管癌的临床观察

Clinical observation of nedaplatin and cisplatin combined with paclitaxel in treatment of advanced esophageal cancer

目的评价并比较奈达铂/顺铂联合紫杉醇治疗晚期食管癌的疗效和不良反应。方法回顾性分析2006年至2011年收治的80例接受奈达铂联合紫杉醇(41例)或顺铂联合紫杉醇(39例)治疗的晚期食管癌患者,对比两种治疗方法的疗效及不良反应。结果奈达铂联合紫杉醇组(TN组)缓解率为26.8%;顺铂联合紫杉醇组(TP组)缓解率为23.1%,两组间差异无统计学意义(P=0.603);TN组和TP组的中位疾病进展时间(time to progress,TTP)和中位总生存时间(overall survival,OS)分别为6个月和5个月、11个月和10个月,差异具有统计学意义(P=0.003,P=0.068)。常见的毒副反应主要是消化道毒性,血液学毒性和脱发。奈达铂组消化道毒性发生率及严重程度显著低于顺铂组,差异具有统计学意义(P=0.0001)。结论奈达铂联合紫杉醇治疗晚期食管癌患者其疗效和总生存与顺铂联合紫杉醇相似,但是在疾病无进展时间和消化道毒性发生率及严重程度上,奈达铂较顺铂有着显著的优势。

Objective To evaluate the efficacy and toxicity of nedaplatin or cisplatin combined with paclitaxel as first-line chemotherapy for patients with advanced esophageal cancer. Method A total of 80 patients with pathologically confirmed and measurable lesions were enrolled and separated into either TN group（nedaplatin ＋ paclitaxel） or TP group（cisplatin ＋ paclitaxel） according to the respective chemotherapy regimen, and then all patients were followed up and the time to progress（TTP） and overall survival（OS） were analyzed. Result In terms of TN group（41 cases） vs TP group（39 cases）, the response rate was 26.8%（11/41） vs 23.1%（10/39）, with no statistical significance（P=0.603）, the median TTP was significantly more in TN group as 6 months vs 5 months（P=0.003）, and the median overall survival rate was also higher as 11 months vs 10 months（P=0.068）; As to the most commonadverse reactions, hematologic and gastrointestinal toxicities were included, however, the incidence of gastrointestinal toxicity in TP group was significantly lower than that in TN group（P=0.0001）. Conclusion The combined chemotherapy of nedaplatin ＋ paclitaxel is as effective as the regimen of cisplatin ＋ paclitaxel, while the TN regimen is superior with longer TTP and less gastrointestinal toxicity.