TFP方案新辅助化疗治疗局部晚期食管癌的疗效及安全性观察

Curative Effect and Safety of Neoadjuvant Chemotherapy with TFP Regime for Treating Local Advanced Esophageal Cancer

目的探讨TFP方案新辅助化疗治疗局部晚期食管癌的疗效及安全性,为局部晚期食管癌的治疗提供依据。方法选取2015年11月至2017年7月在江苏省人民医院住院的62例局部晚期食管癌患者进行研究,所有患者均采用TFP方案新辅助化疗,每化疗2周期后评价其疗效及不良反应,2~4周期后行手术治疗,无法手术切除的患者行根治性放疗,观察患者治疗后的疗效及安全性。结果62例局部晚期食管癌患者经新辅助化疗后完全缓解6例(9.68%),部分缓解25例(40.32%),疾病稳定25例(40.32%),疾病进展6例(9.68%)。成功行根治性手术31例(50.00%),客观缓解率ORR(CR+PR)为49.20%,疾病控制率DCR(CR+PR+SD)为90.32%,术后1 a生存率达96.77%。治疗期间出现的不良反应包括骨髓抑制、消化道反应、肝肾功能损害和神经系统毒性,均为1~4级不良反应,经对症处理后可以缓解。结论TFP方案新辅助化疗治疗局部晚期食管癌能有效缩小肿瘤体积、提高手术切除率,并且不良反应轻,值得临床推广使用。

Objective To explore the efficacy and safety of TFP regime neoadjuvant chemotherapy in the treatment of locally advanced esophageal carcinoma,to provide a reliable basis for the treatment of locally advanced esophageal cancer.Methods 62 patients with locally advanced esophageal cancer who were hospitalized in Jiangsu Province Hospital from November 2015 to July 2017 were enrolled.All patients underwent neoadjuvant chemotherapy with TFP regime.The efficacy and side effects were evaluated every 2 cycles.Operation was performed after 2~4 cycles.Patients who couldn’t be surgically removed treated by radical radiotherapy,and efficacy and safety of patients after treatment in patients were observed.Results Among the 62 patients with locally advanced esophageal cancer,6(9.68%)showed complete remission,25(40.32%)showed partial remission,25(40.32%)showed stable,and 6(9.68%)showed disease progression after neoadjuvant chemotherapy.Radical operation was successfully performed in 31 cases(50.00%),the objective response rate(ORR+PR)was 49.20%,the disease control rate(DCR+PR+SD)was 90.32%,and the 1-year postoperative survival rate was 96.77%.The adverse reactions occurred during the treatment included bone marrow suppression,digestive tract reactions,liver and kidney function damage and neurological toxicity,all of which were grade 1~4 adverse reactions and could be alleviated after symptomatic treatment.Conclusion TFP neoadjuvant chemotherapy for local advanced esophageal cancer could effectively reduce the tumor volume,improve the rates of surgical resection,and the adverse reaction of this scheme is mild.It is worthy of clinical application.