摘要目的 观察分析紫杉醇24 h持续静脉滴注联合奥沙利铂(L-OHP)治疗晚期食管癌的近期疗效和安全性.方法 43例TNM分期为Ⅲ～Ⅳ期晚期食管痛患者中,鳞癌32例,腺癌11例,36例为初治患者,7例曾接受过化疗,其中4例接受过紫杉类治疗,中位年龄56岁.紫杉醇175 ms/m2,24 h持续静脉滴注,第2天L-OHP 130 ms/m2静脉滴注,21 d为1个周期.结果 43例患者共完成130个化疗周期,可评价疗效及毒副反应41例,完全缓解(CR)4例,部分缓解(PR)16例,疾病稳定(SD)9例,疾病进展(PD)12例,有效率(RR)48.7%.其中鳞癌可评价者30例,CR4例,PR 14例,sD 4例,PD 8例,RR 60.0%,腺癌可评价者11例,CR 0例,PR 2例,SD 5例,PD 4例,RR 18.2%,经统计分析鳞癌有效率显著高于腺癌组(P<0.05),该方案主要的不良反应为中性粒细胞减少,Ⅲ～Ⅳ度41.4%,脱发、周围神经毒性、肌肉关节痛等,多以Ⅰ～Ⅱ度为主,发生率分别为60.9%,22%,19.5%.结论 紫杉醇24 h持续静脉滴注联合L-OHP治疗晚期食管癌近期疗效肯定,毒副反应耐受性好,可以考虑作为晚期食管癌的治疗方案.

abstractsObjective To evaluate the efficacy and safety of a 24-hour continuous infusion of paclitaxel in combination with oxaliplatin in the treatment of advanced esophageal cancer.Methods A total of 43 subjects with Ⅲ -Ⅳ stage advanced esophageal cancer were enrolled from March 2008 to June 2009.There were squamous cell carcinoma (n=32) and adenocarcinoma (n = 11 ).Among them, 36 patients had no prior chemotherapy, 7 patients received adjuvant chemotherapy and 4 accepted taxane-based regiments.The median age was 56 years old.All patients were treated with paclitaxel 175 mg/m2 by a 24-hour continuous infusion, oxaliplatin 130 mg/m2 at Day 2, 3 weeks as one cycle.Results Forty-three patients completed 130 cycles ( median: 3 ) .And the efficacy and safety of 41 patients could be evaluated.According to the WHO standard, there were complete response (CR) (n=4), partial response (PR) (n=16), stable disease (SD) (n=9), progressive disease (PD) (n=12) and response rate (RR) 48.7%.Thirty eases of squamous cell carcinoma could be evaluated, CR 4, PR 14, SD 4, PD 8, RR 60.0%;Adenoearcinoma CR 0, PR 2, SD 5, PD 4, RR 18.2%.Statistical test show that RR of squamous was higher than that of adenoearcinoma (P < 0.05).The most common toxicity was hematological.Grade Ⅲ -Ⅳ neutropenia was seen in 16 patients (41.4%), alopocia 60.9%, vomiting 26.8%, neuropathy 22% and myalgia 19.5%.Most of them were of Grade Ⅰ - Ⅱ.Conclusions The efficacy of a 24-hour continuous infusion of paclitaxel plus oxaliplatin in the treatment of advanced esophageal cancer is excellent.All toxicities are well tolerated.So this protocol may be considered a main regimen in the treatment of advanced esophageal cancer.