白蛋白结合型紫杉醇和普通紫杉醇联合顺铂方案同步放疗治疗局部晚期食管鳞状细胞癌的效果比较

Efficacy comparison of albumin-bound paclitaxel and conventional paclitaxel combined with cisplatin and concurrent radiotherapy in treatment of locally advanced esophageal squamous cell carcinoma

目的探讨白蛋白结合型紫杉醇(Nab-P)和普通紫杉醇联合顺铂方案同步放疗治疗局部晚期食管鳞状细胞癌患者的效果及不良反应。方法选取2016年11月至2020年5月宿迁市第一人民医院收治的49例局部晚期食管鳞状细胞癌患者,其中23例采用Nab-P联合顺铂方案同步放疗(NP组),26例采用普通紫杉醇联合顺铂方案同步放疗(TP组),化疗共2个周期。放疗结束后1个月评估疗效,对比两组治疗方案的疗效及不良反应。结果NP组客观缓解率为78.3%(18/23),疾病控制率为100.0%(23/23);TP组客观缓解率为61.5%(16/26),疾病控制率为92.3%(24/26);NP组客观缓解率和疾病控制率均较TP组高,差异均无统计学意义(均P>0.05)。常见的不良反应主要为脱发、食欲减退、骨髓抑制、放射性食管炎、放射性肺炎、全身乏力和肌痛。NP组3~4级骨髓抑制的发生率(8.7%,2/23)低于TP组(38.5%,10/26),差异有统计学意义(χ^(2)=4.35,P=0.037)。NP组肌痛的发生率(26.1%,6/23)低于TP组(61.5%,16/26),差异有统计学意义(χ^(2)=4.85,P=0.028)。结论Nab-P联合顺铂方案同步放疗治疗局部晚期食管鳞状细胞癌患者疗效较好,不良反应的发生率较普通紫杉醇联合顺铂方案同步放疗低,安全性较好。

Objective To explore the clinical efficacy and adverse reactions of albumin-bound paclitaxel(Nab-P)and conventional paclitaxel combined with cisplatin and concurrent radiotherapy for the treatment of patients with locally advanced esophageal squamous cell carcinoma.Methods Forty-nine patients with locally advanced esophageal squamous cell carcinoma admitted to the First People's Hospital of Suqian from November 2016 to May 2020 were included.Of the 49 patients,23 cases were treated with Nab-P combined with cisplatin and concurrent radiotherapy(NP group),26 cases were treated with conventional paclitaxel combined with cisplatin and concurrent radiotherapy(TP group).All patients received 2 cycles of chemotherapy.The curative efficacy was evaluated one month after the end of radiotherapy,and the curative effect and adverse reactions of the two treatment regimens were compared.Results The objective remission rate in NP group was 78.3%(18/23),and the disease control rate was 100.0%(23/23).The objective response rate in TP group was 61.5%(16/26),and the disease control rate was 92.3%(24/26).The objective response rate and disease control rate in NP group were higher than those in TP group,but the differences were not statistically significant(both P>0.05).The common adverse reactions were mainly hair loss,loss of appetite,bone marrow suppression,radiation esophagitis,radiation pneumonia,malaise and myalgia.The incidence rate of grade 3-4 acute bone marrow suppression in NP group(8.7%,2/23)was lower than that in TP group(38.5%,10/26),and the difference was statistically significant(χ^(2)=4.35,P=0.037).The incidence rate of myalgia in NP group(26.1%,6/23)was lower than that in TP group(61.5%,16/26),and the difference was statistically significant(χ^(2)=4.85,P=0.028).Conclusions Nab-P combined with cisplatin and concurrent radiotherapy has good efficacy in the treatment of patients with locally advanced esophageal squamous cell carcinoma,and the incidence rate of adverse reactions is lower than that of conventional paclitaxel combined with cisplatin and concurrent radiotherapy,so that the regimen is safe.