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目的探讨多西紫杉醇与顺铂同步放疗治疗晚期食管癌临床效果及安全性。方法选取我院2008年5月至2009年3月收治晚期食管癌患者137例,采用随机数字表法分为两组,其中对照组69例,采用顺铂20mg/m2,5-氟尿嘧啶,400mg/m2联用治疗;实验组68例,采用多西紫杉醇,120mg/m2,顺铂,20mg/m2联用治疗;疗程均为3周;同时两组患者均采用三维适形放疗,总剂量为55-65gy,疗程均为6周;比较两组患者临床治疗总有效率,中位生存时间,1、2、3年生存率以及毒副反应发生率等。结果对照组患者中完全缓解11例,部分缓解35例,稳定14例,进展8例,治疗总有效例数为46例,临床治疗总有效率为66.7%;实验组患者中完全缓解27例,部分缓解34例,稳定5例,进展2例,治疗总有效例数为61例,临床治疗总有效率为89.7%;实验组患者临床治疗总有效率明显高于对照组,组间比较差异显著(P<0.05);实验组患者中位生存时间明显高于对照组,组间比较差异显著(P<0.05);实验组患者1、2、3年生存率均明显高于对照组,组间比较差异显著(P<0.05);同时对照组患者发生毒副作用48例,毒副作用发生率为69.6%;实验组患者发生毒副作用49例,毒副作用发生率为72.1%;。两组患者毒副作用发生率明组间比较无显著差异(P>0.05)。结论多西紫杉醇与顺铂同步放疗治疗晚期食管癌能够有效延缓疾病进展,提高临床中位生存时间及治疗后生存率,且并无不良反应显著增加。
Objective To investigate the clinical efficacy and safety of docetaxel combined with cisplatin in the treatment of advanced esophageal cancer. Methods A total of 137 patients with advanced esophageal cancer who were treated in our hospital from May 2008 to March 2009 were randomly divided into two groups (control group, 69 cases) with cisplatin 20mg / m2, fluorouracil 400mg / m2 combined treatment; experimental group 68 cases, the use of docetaxel, 120mg / m2, cisplatin, 20mg / m2 combined treatment; treatment were 3 weeks; the same time, two groups of patients were treated with three-dimensional conformal radiotherapy, a total dose of 55 -65gy, the course of treatment was 6 weeks. The total effective rate, median survival time, 1, 2, 3 years survival rate and the incidence of toxic and side effects were compared between the two groups. Results In the control group, 11 patients were completely relieved, 35 were partially relieved, 14 were stable, and 8 were progress. The total effective treatment was 46 and the total effective rate was 66.7%. In the experimental group, 27 were completely relieved, Partial response in 34 cases, stable in 5 cases, progression in 2 cases, the total effective treatment cases were 61 cases, the total effective rate of clinical treatment was 89.7%; experimental group patients with clinical treatment was significantly higher than the effective rate of the control group, significant difference (P <0.05). The median survival time in the experimental group was significantly higher than that in the control group (P <0.05). The 1, 2, 3-year survival rates in the experimental group were significantly higher than those in the control group (P <0.05). At the same time, there were 48 cases of toxic and side effects in the control group, the incidence of toxic and side effects was 69.6%; 49 cases of toxic and side effects in the experimental group, the incidence of toxic and side effects was 72.1%. The incidence of side effects in both groups showed no significant difference (P> 0.05). Conclusions The combination of docetaxel and cisplatin in the treatment of advanced esophageal cancer can effectively delay the progression of the disease, improve the median survival time and the survival rate after treatment, with no significant increase in adverse reactions.