多烯紫杉醇联合奈达铂同步放化疗治疗局部中晚期食管癌疗效观察

Therapeutic effect of Docetaxel and Nedaplatin in synchronization chemoradiation on local advanced esophageal cancer

目的 探讨局部中晚期食管癌患者应用多烯紫杉醇联合奈达铂同步放化疗的治疗效果和安全性。方法 42例局部中晚期食管癌患者随机分为观察组和对照组各21例,2组均采用三维适形放疗,并于放疗第1天同步进行化疗,对照组化疗应用顺铂＋多烯紫杉醇方案,观察组应用奈达铂＋多烯紫杉醇方案。2组化疗均每21d为1个周期,出现Ⅱ度及以上血小板减少症、Ⅱ度以上粒细胞减少症患者停止化疗。比较2组同步放化疗结束时及治疗3个月后疗效及不良反应发生情况,随访观察1a生存率。结果 对照组完成化疗周期55个,观察组完成60个;观察组同步放化疗结束、治疗3个月后有效率（85.71%、90.48%）和疾病控制率（100.00%、100.00%）与对照组（76.19%、80.95%和90.48%、95.24%）比较差异均无统计学意义（P〉0.05）;观察组1a生存率（80.95%）高于对照组（61.90%）（P〈0.05）;放化疗期间,观察组Ⅰ~Ⅱ、Ⅲ~Ⅳ级食欲下降（28.57%、23.81%）、恶心（38.10%、9.52%）、呕吐（14.29%、9.52%）、肾功能损害（23.81%、14.29%）发生率均低于对照组[食欲下降（61.90%、38.10%）、恶心（71.43%、28.57%）、呕吐（57.14%、33.33%）、肾功能损害（47.62%、38.10%）],差异均有统计学意义（P〈0.05）。结论 与多烯紫杉醇联合顺铂同步放化疗比较,局部中晚期食管癌患者应用多烯紫杉醇联合奈达铂同步放化疗治疗胃肠道不良反应较轻,1a生存率较高。

Objective To observe the effect and safety of Docetaxel and Nedaplatin in synchronization chemoradiation for local advanced esophageal cancer. Methods Forty-two patients with local advanced esophageal cancer were randomly divided into observation group and control group, with 21 patients in each group. Both two groups received three-dimensionalconformal radiation therapy. By day 1 of radiotherapy, control group received Cisplatin plus Docetaxel, and observation group received Nedaplatin plus Docetaxel, for 21 days as one cycle, which ceased if ≥ 2 degree thrombocytopenia or 〉22 degree granulocytopenia occurred. The adverse reactions were observed and compared at the end of chemoradiation and 3 months after chemoradiation between two groups. The 1-year survival was observed. Results Control group completed 55 cycles of chemotherapy and observation group completed 60 cycles. The effective rates （85.71%, 90.48%） and disease control rates （100.00%, 100.00%） in observation group showed no significant differences in comparison with those in control group （76. 19%, 80. 95%, 90. 48%, 95. 24%） at the end of chemoradiation and 3 months after chemoradiation （P〉0.05）. The 1-year survival was significantly higher in observation group （80.95%） than that in control group （61.90%） （P〈0.05）. The incidences of Ⅰ to Ⅱdegree and Ⅲ to Ⅳ degree appetite losing （28. 57%, 23. 81%）, nausea （38. 10%, 9. 52%）, vomiting （14. 29%, 9. 52%） and renal damage （23.81%, 14.29%） in observation group were significantly lower than those in control group （61. 90%, 38. 10% 71.43%, 28. 57% 57. 14%, 38. 33%; 47. 62%, 38. 10%） （P〈0.05）. Conclusion Docetaxel plus Nedaplatin is superior to Cisplatin plus Docetaxel in synchronization chemoradiation on local advanced esophageal cancer, with mild adverse reaction and high 1-year survival.