紫杉醇脂质体联合奈达铂双周方案在晚期食管癌一线治疗中的临床探索

Clinical exploration of biweekly paclitaxel liposome combined with nedaplatin as first-line treatment for advanced esophageal cancer

目的评价紫杉醇脂质体联合奈达铂双周方案用于一线治疗晚期食管癌的疗效及安全性。方法选取接受紫杉醇脂质体联合奈达铂双周重复方案治疗的37例有可测量病灶的晚期食管癌患者,评估患者的总有效率、疾病控制率、总生存情况、无进展生存情况及不良反应发生情况。结果37例可以评价疗效的晚期食管癌患者的中位化疗周期为5个周期;部分缓解16例,疾病稳定10例,疾病进展11例,总有效率为43.2%(16/37),疾病控制率为70.3%(26/37)。37例晚期食管癌患者的中位总生存期为11.3个月(95%CI:9.3~13.3),中位无进展生存期为3.5个月(95%CI:1.1~6.0)。常见的不良反应包括骨髓抑制,其中3~4级白细胞减少的发生率为18.9%(7/37),3~4级中性粒细胞减少的发生率为24.3%(9/37),均经对症治疗后恢复正常;未见神经毒性及过敏反应。结论紫杉醇脂质体联合奈达铂双周方案一线治疗晚期食管癌的疗效确切,安全性较好。

Objective To evaluate the efficacy and safety of the biweekly program of paclitaxel liposome combined with nedaplatin as a first-line treatment for advanced esophageal cancer.Method A total of thirty-seven patients with advanced esophageal cancer and measurable lesions were selected and these subjects were treated with combined therapy of paclitaxel liposome and nedaplatin,2 weeks a cycle.Besides,their overall response rate,disease control rate,overall survival,progress free survival,and adverse reactions were assessed.Result The median chemotherapy cycles of all thirtyseven patients with advanced esophageal carcinoma and measurable efficacy was 5.Among these subjects,16 patients achieved partial response,10 achieved stable disease and 11 experienced progressive disease.The overall response rate was 43.2%(16/37),disease control rate was 70.3%(26/37).The median overall survival was 11.3 months(95%CI:9.3-13.3),and median progress free survival was 3.5 months(95%CI:1.1-6.0).The most common adverse event was bone marrow suppression,including 18.9%(7/37)with leukocytopenia at 3-4 degrees and 24.3%(9/37)with neutropenia at 3-4 degrees,which were all recovery after symptomatic treatment and no neurotoxicity or allergic reaction was found.Conclusion Paclitaxel liposome combined with nedaplatin is effective and tolerable in the first-line treatment of advanced esophageal carcinoma.