白蛋白结合型紫杉醇治疗晚期食管癌的临床观察

Effi cacy of nanoparticle albumin-bound paclitaxel on advanced esophageal cancer

目的探讨白蛋白结合型紫杉醇联合顺铂、替吉奥或贝伐珠单抗治疗晚期食管癌的临床疗效及安全性。方法回顾分析2014年1月-2015年10月本院收治的58例晚期食管癌初治患者。实验组（n=28）接受新型白蛋白结合型紫杉醇方案进行化疗,对照组（n=30）接受传统紫杉醇方案进行化疗。实验组年龄47~77岁,中位年龄63岁,男性27例,女性1例;对照组年龄49~81岁,中位年龄65岁,男性26例,女性4例;两组患者均为Ⅳ期食管癌患者,基线特征无统计学差异（P〉0.05）。各组治疗21 d为1个周期,每治疗2个周期评价治疗效果,每个周期评价不良反应。结果对照组PR 7例、SD 15例、PD 8例,中位无进展生存时间4个月;实验组PR 15例、SD 10例、PD 3例,中位无进展生存时间5个月,两组疗效差异有统计学意义（P〈0.05）。两组主要不良反应为血液学毒性、脱发和外周神经毒性,多以Ⅰ~Ⅱ度为主,均可耐受。结论基于新型白蛋白结合型紫杉醇的化疗方案对晚期食管癌显示出良好的疗效,且不良反应较小,值得临床推广应用。

Objective To evaluate the clinical efficacy and safety of nanoparticle albumin-bound paclitaxel（Nab-P） in combination with cisplatin, Gio or bevacizumab in the treatment of advanced esophageal cancer. Methods Fifty-eight patients with advanced esophageal cancer in Chinese PLA General Hospital from January 2014 to October 2015 were included in this study. Patients in control group（n=30） were treated with traditional Paclitaxel and patients in experimental group（n=28） were treated with Nab-P（270 mg/m2, d1, d8） based chemotherapy. The median age of patients in experimental group was 63 years old（ranging from 47 to 77 years old）, with 27 males and 1 female. The median age of patients in control group was 65 years old（ranging from 49 to 81 years old）, with 26 males and 4 females. There were no statistically significant differences in baseline data between patients in two groups（P〉0.05）. Efficacy was evaluated every two cycles and adverse effects were evaluated every cycle. Results In control group, 7 patients achieved partial response（PR）, 15 patients had stable disease（SD）, 8 patients had progressive disease（PR） with the median progression-free survival of 4 months. In experimental group, 15 patients achieved PR, 10 patients had SD, 3 patients had PD with the median progression-free survival of 5 months. The efficacy of two treatment regimes had significant difference（P〈0.05）. The adverse events in two groups were mainly hematologic toxicity, hair loss and peripheral neurotoxicity of I-II degree.Conclusion Nab-P plus cisplatin, Gio or bevacizumab shows favorable efficacy and less side effects, which can be an effective therapy for patients with advanced esophageal cancer.