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紫杉醇联合奈达铂治疗晚期食管癌

作者:张付红 樊青霞 Fu-hong Qing-xia紫杉醇奈达铂治疗晚期食管癌esophagealcancertreatmentcoursesintravenousinfusion不良反应paclitaxel中位生存时间疾病进展时间氟尿嘧啶advancedcarcinoma疗效评价标准survivaltimeresponserate有效率顺铂sideeffects统计学意义

摘要:目的 观察紫杉醇联合奈达铂方案治疗晚期食管癌的疗效和不良反应.方法 将60例晚期食管癌患者随机分为两组,紫杉醇+奈达铂组30例,应用紫杉醇150 mg/m2,第1天,奈达铂80 mg/m2,第2~4天;5-氟尿嘧啶+顺铂组30例,用5-氟尿嘧啶500 mg/m2,第1~5天,顺铂80 mg/m2,第2~4天;两组均21 d为1个周期,2个周期后按实体瘤疗效评价标准(RECIST)评价疗效,按WHO抗癌药物急性与亚急性表现和分度标准评价不良反应.结果 紫杉醇+奈达铂组30例,有效率为50%,中位疾病进展时间6.7个月,中位生存时间11.8个月;5-氟尿嘧啶+顺铂组30例,有效率36.7%,中位疾病进展时间3.9个月,中位生存时间8.9个月,两组比较差异有统计学意义.紫杉醇+奈达铂组不良反应稍重,主要表现为白细胞减少、血小板下降和脱发,但是可耐受.结论 紫杉醇联合奈达铂治疗晚期食管癌的疗效较高,不良反应可耐受. Abstract: Objective To observe the efficacy and the side effects of paclitaxel combined with nedaplatin in treating advanced esophageal cancer. Methods Sixty patients with advanced carcinoma of esophagus were divided into two groups.Thirty ptients were given paclitaxel 150 mg/m2 intravenous infusion on the first day, and nedaplatin 80 mg/m2 intravenous infusion divided into d 2-4. Thirty patients were given 5-Fu 500 mg/m2 on d 1-5,and cisplatin 80 mg/m2 intravenous infusion divided into d 2-4. Cycles were repeated every 21 days. After two consecutive treatment courses, the evaluation of the efficacy and toxicities were carried out. Results The overall response rate of PTX+NDP group was much higher than that of 5-Fu +DDP group(50% vs 36.7%, P<0.01).The median time to progress was 6.7 months vs 3.9 months.The median survival time was 11.8 months vs 8.9 months.The difference was obvious.The adverse effects of the former were more sever than that of the later.The major adverse effects were bonemarrow depression, thrombocytopenia and alopecia. Conclusions Paclitaxel co

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