多西他赛联合奥沙利铂治疗晚期食管癌的临床分析

Clinical Analysis of Docetaxel Combined with Oxaliplatin in Patients with Advanced Esophageal Cancer

目的评估多西他赛联合奥沙利铂治疗晚期食管癌的疗效及不良反应。方法选择2010年3月至2013年3月荆州市中心医院收住院、经病理组织学或细胞学及影像学确诊的食管癌晚期患者96例,依据随机数字表法分为对照组和研究组,各48例。两组均给予多西他赛75 mg/m^2,对照组联合顺铂80-100 mg/m^2,研究组联合奥沙利铂135 mg/m^2;每21天化疗1次。比较两组患者的有效率、疾病进展时间（TTP）、中位生存期、Kamofsky评分及不良反应情况。结果两组临床疗效比较差异差异无统计学意义（P〉0.05）,研究组Kamofsky评分好转率显著高于对照组（66.7%比43.8%,P〈0.05）。研究组中位生存期为（18.2±1.3）个月,TTP为（9.3±0.4）个月,对照组中位生存期为（16.3±1.0）个月,TTP为（8.7±0.3）个月,两组TTP、中位生存期比较差异无统计学意义（P〉0.05）。研究组血小板减少、腹泻、恶心呕吐及肝损伤、肾损伤明显发生率低于对照组,但神经毒性发生率高于对照组,差异均有统计学意义（P〈0.05）。结论多西他赛联合奥沙利铂治疗晚期食管癌临床疗效满意,且肝肾功能、胃肠道及骨髓抑制等不良反应比联用顺铂明显减少,推荐该方案在临床得到合理的应用,并在实际用药中个体化调整奥沙利铂的用药剂量。

Objective To evaluate the efficacy and adverse reactions of docetaxel combined with oxali-platininpatientswithadvancedesophagealcancer.Methods 96patientswithesophagealcanceradmitted to the Jingzhou Central Hospital from March 2010 to March 2013,hospitalized late stage by histology or cytol-ogy and radiologically confirmed cases,patients were randomly divided into research group and control group, each of 48 cases.Both groups received docetaxel 75 mg/m^2 , control group combined with cisplatin 80-100 mg/m^2 ,study group combined with oxaliplatin 135 mg/m^2 .All patients received chemotherapy once ev-ery 21 d.Both groups of patients in efficacy,disease progression （TTP）,the median survival time,Kamofsky score and associated adverse reactions were compared.Results There was no significant difference in effi-ciency（ P〉0.05） .Kamofsky score improvement rate in the study group was significantly higher than that in control group（66.7% vs 43.8%,P 〈0.05）.The median survival and TTP of study group were （18.2 ± 1.3） months and （ 9.3 ±0.4 ） months, the control group were （ 16.3 ±1.0 ） months and （ 8.7 ± 0.3） months,no statistical significance in two groups （P〉0.05）.The incidence rates of thrombocytopenia, degree diarrhea, nausea and vomiting, neurotoxicity, liver injury, renal impairment in study group were significantly lower than the control group,neurotoxicity was higher than that of control group（P 〈0.05）. Conclusion Clinical effect of docetaxel combined with oxaliplatin in the treatment of advanced esophageal cancer is satisfactory, and the function of liver and kidney, gastrointestinal and bone marrow suppression and other adverse reactions were reduced than that combined with cisplatin ,it recommend be applied reasonably in clinical,and be closely observed with its possible neurotoxicity by adjusting the dose.