放疗同步紫衫醇加奈达铂方案与同步单药奈达铂方案治疗局部晚期食管癌的比较研究.docVIP

放疗同步紫衫醇加奈达铂方案与同步单药奈达铂方案治疗局部晚期食管癌的比较研究 　　【摘 要】目的：比较放疗同步紫杉醇加奈达铂方案（TP）和同步单药奈达铂（NDP）方案治疗局部晚期食管癌近期疗效及毒副反应。方法：局部晚期食管癌，共48例，随机分为两组，放疗同步TP（紫杉醇+奈达铂）方案23例和放疗同步单药NDP（奈达铂）方案25例，同期行根治性放疗。结果：其中TP组总有效率91.3%；NDP组总有效率为84%，P0.05，总有效率两组无统计学意义，Ⅱ-Ⅲ度血液学不良反应： TP 组69.54%，NDP组28%，有显著性差异；Ⅱ-Ⅲ度级非血液学毒性主要为放射性食管炎，TP 组52.17%，NDP16.00%，有显著性差异。结论：两组治疗方案均是治疗局部晚期食管癌的较好方案，根据患者具体情况，选择不同的治疗方案。 　　【关键词】食管癌 同步放化疗 紫杉醇 奈达铂 　　【中图分类号】R735.1 【文献标识码】A 【文章编号】1004-7484（2014）03-01291-02 　　Clinical study of Paclitaxel and Nedaplatin versus Nedaplatin in Concurrent Chemoradiotherapy for Locally Advanced Esophageal Carcinoma 　　CHEN Li， YUAN Yi-feng， JIANG Ya-qi， WU Wen-juan 　　（Department of Oncology， Northern Jiangsu Peoples Hospital affiliated to Yangzhou University， Yangzhou Jiangsu 225001， China） 　　【Abstract】Objective： To compared efficacy and toxicities of Paclitaxel plus Nedaplatin（TP） and Nedaplatin （NDP）combined with radiotherapy in the treatment of patient with locally advanced esophageal carcinoma. Methods： Total of 46 locally advanced esophageal carcinoma patients were randomly divided into two groups： 23 patients were treated by TP and the other 25 patients were treated by NDP. All patients received concurrent radical radiotherapy. Results： In TP group， an overall response rate（ ORR） was 91.3%； In NDP group， an overall response rate was 85% ， The ORRs were not significantly different between the 2 groups. Grade 2- 3 hematologic toxicities were 69.54% in TP group， and 28% in NDP group，the difference was statistically significant； radiation esophagitis was the main grade 2-3 non-hematological toxicity occurred 52.17% in TP group， and 16.0% in NDP group， the difference was statistically significant. Conclusion： Both treatments are effective for locally advanced esophageal carcinoma patients and they should be chosen according to the general condition of patients. 　　【Keywords】Esophageal cancer； Concurrent chemoradiotherapy； Paclitaxel； Nedaplatin 　　我国是食管癌的高发国家，全世界食管癌死亡率以中国为最高。多数病人就诊时已为中晚期，对失去手术治疗机会或是拒绝