白蛋白紫杉醇联合放疗治疗局部晚期食管癌的疗效

Efficacy analysis of albumin paclitaxel and radiotherapy in locally advanced oesophageal cancer

目的同步放化疗是局部晚期食管癌不能手术的首选治疗,紫杉类化疗药物联合顺铂同步放化疗现已广泛应用于临床,本研究目的为观察白蛋白紫杉醇联合顺铂同步放化疗治疗局部晚期食管癌的安全性及临床疗效。方法回顾性分析2018年1月—2019年7月安徽省第二人民医院放射治疗科收治的局部晚期食管癌患者共计45例,均行根治性同步放化疗,其中22例行白蛋白紫杉醇+顺铂(试验组)同步化疗及23例行顺铂(对照组)同步放化疗,同步放化疗治疗结束后3个月行胸部CT、钡餐等检查评价临床疗效,并电话随访患者1年无疾病生存率。结果白蛋白紫杉醇+顺铂同步放化疗组客观缓解率(objective response rate,ORR)为77.3%,顺铂同步放化疗组客观缓解率为47.8%,2组差异无统计学意义(P<0.05);白蛋白紫杉醇+顺铂同步放化疗组随访1年的总生存率(overall survival rate,OS,90.2%)高于顺铂同步放化疗组(78.0%),虽然2组患者不良反应发生率比较白细胞减少及周围神经损伤差异有统计学意义(P<0.05),但大多为1~2级反应,患者可耐受。结论局部晚期食管癌患者给予白蛋白紫杉醇联合顺铂同步放化疗治疗,临床疗效较好,1年生存率较高,不良反应可耐受。

Objective Synchronous radiotherapy and chemotherapy is the first choice for inoperable treatment of locally advanced oesophageal cancer.Taxane chemotherapy drugs combined with cisplatin and concurrent radiotherapy and chemotherapy have been widely used in clinical practice.Therefore,the purpose of this study is to observe the safety and clinical efficacy of albumin paclitaxel combined with cisplatin and concurrent radiotherapy and chemotherapy in locally advanced oesophageal cancer.Methods Retrospective analysis was performed on a total of 45 patients with locally advanced esophageal cancer admitted to the Department of Radiotherapy of the Second People’s Hospital of Anhui Province from January 2018 to July 2019.All received radical concurrent radiotherapy and chemotherapy,Among them,22 patients received concurrent chemotherapy with albumin paclitaxel and cisplatin(experimental group)and 23 patients received concurrent chemoradiotherapy with cisplatin(control group),Three months after the end of concurrent radiotherapy and chemotherapy,chest CT,barium meal and other examinations were performed to evaluate the clinical efficacy,and the patients were followed up by telephone for a 1-year disease-free survival rate.Results The objective response rate(ORR)of the albumin paclitaxel+cisplatin concurrent radiotherapy and chemotherapy group was 77.3%,and the ORR of the cisplatin concurrent radiotherapy and chemotherapy group was 47.8%.The difference between the two groups was not statistically significant(P<0.05).The overall survival rate(90.2%)of the albumin paclitaxel+cisplatin concurrent radiotherapy and chemotherapy group was higher than that of the cisplatin concurrent radiotherapy group(78.0%).A statistically significant difference was observed in peripheral nerve injury(P<0.05),but most of them were grade 1 to 2 reactions,which could be tolerated by patients.Conclusion The clinical effect of albumin paclitaxel combined with cisplatin concurrent radiotherapy and chemotherapy on locally advanced oesophageal cancer is good,the 1-year survival rate is high,and the adverse reactions are tolerable.