【摘要】 目的:本临床研究采用铂类(顺铂或卡铂)联合多西他赛(docetaxel)一线治疗晚期食管癌,探讨晚期食管癌的一线治疗及预后因素。方法:2006年8月至2008年10月,共有36例患者入选,其中27例采用顺铂(DDP)联合docetaxel(DT)方案进行治疗,9例采用卡铂(CBP)联合docetaxel(CT)方案进行治疗;DT方案:DDP25mg/m2,第1～3天或第1～4天使用;docetaxel75mg/m2,第1天使用,以上用法3周重复。CT方案:DT方案中把DDP替换为CBPAUC=5。结果:入选36例患者均能进行疗效和毒副反应评价,完全缓解(CR)1例;部分缓解(PR)17例,稳定(NC)10例,进展(PD)7例,总有效率为50.00%;DT、CT方案有效率分别为59.26%及22.22%(P=0.121)。较常见的毒副作用为恶心呕吐,经对症支持治疗后均见好转。中位随访时间为8.70个月,全组36例患者中位生存期为10.50个月,95%的可信区间为7.36～13.64。COX单因素回归分析提示:性别、年龄、体重下降及治疗前血红蛋白对生存的影响均没有统计学意义(P>0.05),而治疗前行为状态对生存的影响差异有统计学意义(P=0.036)。结论:铂类联合多西他赛一线治疗晚期食管癌疗效好,毒副反应可耐受;治疗前行为状态是影响生存的独立因素,行为状态良好治疗后预后也较好。更多还原

【Abstract】 AIM:To evaluate the efficacy and safety of the regimen based on platinum compound plus docetaxel in the treatment of advanced esophageal carcinoma as first-line drug,and to further explore prognostic factors of advanced esophageal carcinoma by survival analysis.METHODS:From August 2006 to October 2008,36 patients with advanced esophageal carcinoma were enrolled in the study,and non-randomly assigned to docetaxel 75 mg/m2 in the first day every 3 weeks,combined with cisplatin 25 mg/m2 in the first day to third day or in the first day to forth day(DT,n=27),or with carboplatin AUC=5 on day 1(CT,n=9).RESULTS:The curative and toxic side effects were evaluated to the 36 patients.There were 1 complete respone,17 partial respone,11 no changes and 7 progressive disease in 36 patients with total response rate of 50.00%.The response rates of DT,CT regimen were 59.26% and 22.22%(P=0.121).The major side effects were nausea-vomiting,all side effects were reversible by symptomatic treatment.After a median follow-up of 8.70 months,the overall median survival was 10.50 months(95% CI 7.36 to 13.64 months).The COX univariate regression analysis suggested there was no correlation with sex,age and the hemoglobin of before chemotherapy with existence.But there was statistical significance between the behavior state of chemotherapy and the existence(P=0.036).CONCLUSION:The regimen based on platinum compound plus docetaxel is tolerable and more effective as a first-line treatment for advanced esophageal carcinoma.Patients with good performance status before chemotherapy indicates good prognosis and it is an independent factor affecting survival for advanced esophageal carcinoma.更多还原