国际肿瘤学杂志

国际肿瘤学杂志 ›› 2017, Vol. 44 ›› Issue (10): 736-739.doi: 10.3760/cma.j.issn.1673-422X.2017.10.004

• 论著 • 上一篇    下一篇

紫杉醇联合顺铂同期放疗治疗初治局部晚期 食管鳞状细胞癌患者的Ⅱ期临床研究

安成，张焕江   

  1. 712000 陕西省咸阳市第一人民医院药剂科（安成）；陕西省延安市人民医院药剂科（张焕江）
  • 出版日期:2017-10-08 发布日期:2017-11-08
  • 通讯作者: 张焕江 E-mail:Jiangxinfeng112@163.com

Phase Ⅱ clinical study of paclitaxel and cisplatin combined with concurrent radiotherapy in the treatment of locally advanced esophageal squamous cell carcinoma

An Cheng, Zhang Huanjiang   

  1. Department of Pharmacy, Xianyang First People′s Hospital of Shaanxi Province, Xianyang 712000, China
  • Online:2017-10-08 Published:2017-11-08
  • Contact: Zhang Huanjiang E-mail:Jiangxinfeng112@163.com

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摘要： 目的研究紫杉醇联合顺铂同期放疗治疗初治局部晚期食管鳞状细胞癌患者的Ⅱ期临床效果。方法选择2014年1月至2016年1月在我院就诊的局部晚期食管鳞状细胞癌患者63例，按照随机数表法将患者分为研究组（32例）和对照组（31例），所有患者均采用三维适形放疗，对照组采用5氟尿嘧啶联合顺铂治疗，研究组采用紫杉醇联合顺铂治疗，21 d为1个疗程，连续化疗2个疗程。评价两组患者的治疗效果和化疗期间不良反应情况。检测两组患者化疗前后癌胚抗原（CEA）、CA125和CA50等肿瘤标志物水平。对患者进行随访，记录患者生存率。结果研究组患者有效率为93.75%，高于对照组的74.19%，差异有统计学意义（χ2=4.510，P=0.034）。与对照组相比，研究组患者放射性食管炎（Z=2.076，P=0.038）、神经毒性（Z=3.806，P＜0.001）、胃肠反应（Z=2.374，P=0.018）、白细胞减少（Z=1.979，P=0.048）不良反应明显减轻。化疗后观察组和对照组患者肿瘤标志物CEA、CA125和CA50水平均较治疗前显著降低（均P<0.05），且研究组化疗后肿瘤标志物CEA、CA125和CA50水平显著低于对照组（均P<0.05）。研究组患者1年生存率为90.63%，显著高于对照组的70.97%，差异有统计学意义（χ2=4.287，P=0.038）。结论紫杉醇联合顺铂同期放疗能够有效提高局部晚期食管鳞状细胞癌的Ⅱ期治疗效果，化疗过程中不良反应较小，可有效提高患者近期生存率，具有较好的临床使用价值。

关键词: 食管肿瘤, 治疗结果, 顺铂, 紫杉醇

Abstract: ObjectiveTo study the phase Ⅱ clinical efficacy of paclitaxel and cisplatin combined with concurrent radiotherapy in the treatment of locally advanced esophageal squamous cell carcinoma. MethodsSixtythree cases of locally advanced esophageal squamous cell carcinoma patients were selected from January 2014 to January 2016 in our hospital. All patients were randomly divided into the study group (32 cases) and control group (31 cases) according to random number table method. All patients were treated with threedimensional conformal radiotherapy, the control group was treated with 5fluorouracil and cisplatin, and study group was treated with paclitaxel combined with cisplatin, 21 days for a course of treatment, continuous 2 cycles of chemotherapy. The therapeutic effects and adverse reactions of the two groups of patients were evaluated. The levels of tumor markers such as carcino embryonic antigen (CEA), CA125 and CA50 were detected in the two groups before and after chemotherapy. The patients were followed up, and the survival rates were recorded. ResultsThe effective rate of the patients in the study group was 93.75%, higher than that of the control group (74.19%, χ2=4.510, P=0.034). Compared with the control group, the radiation esophagitis (Z=2.076, P=0.038), neurotoxicity (Z=3.806, P＜0.001), gastrointestinal reactions (Z=2.374, P=0.018), leukopenia (Z=1.979, P=0.048) were significantly lighter in the study group. After chemotherapy, the levels of CEA, CA125, CA50 of study group and control group were significantly lower than those before chemotherapy (all P＜0.05), and the levels of study group after chemotherapy were significantly lower than those of the control group (all P＜0.05). The 1year survival rate of the patients in the study group was 90.63%, which was significantly higher than that in the control group (70.97%), and the difference was statistically significant (χ2=4.287, P=0.038). ConclusionPaclitaxel and cisplatin combined with concurrent radiotherapy can improve the phase Ⅱ therapeutic effect of locally advanced esophageal squamous cell carcinoma, the toxicity of chemotherapy in patients is low, effectively improve the shortterm survival rate, with better clinical value.

Key words: Esophageal neoplasms, Treatment outcome, Cisplatin, Paclitaxel