Ilson D H, Wadleigh R G, Leichman L P, Kelsen D P
Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Ann Oncol. 2007 May;18(5):898-902. doi: 10.1093/annonc/mdm004. Epub 2007 Mar 9.
The purpose of the study was to evaluate the efficacy of weekly paclitaxel (Taxol) in advanced esophageal cancer.
One hundred and two patients with advanced esophageal cancer were treated with paclitaxel 80 mg/m2 weekly over a 1-h infusion. One cycle was defined as 4 weeks of therapy. Ninety-five patients were assessable for toxicity and 86 patients who completed at least two cycles of treatment were assessable for response. Sixty-six patients had adenocarcinoma (66%) and 65 patients (68%) had no prior chemotherapy.
A median of three cycles was delivered (range 1-11). Partial responses (PRs) were seen in 11 patients [13%, 95% confidence interval (CI) 6% to 20%]. In patients without prior chemotherapy, PRs were seen in 10 patients (15%, 95% CI 6% to 24%), with comparable response in adenocarcinoma (8/50, 16%) and squamous carcinoma (2/15, 13%). Limited response was seen in patients with prior chemotherapy (1/21, 5%). The median duration of response was 172 days. The median survival was 274 days. Therapy was well tolerated with minimal hematologic or grade 3 or 4 toxicity.
Weekly paclitaxel has limited activity in esophageal cancer. The median survival, modest activity, and tolerance of therapy indicate that weekly paclitaxel may be an option in patients unable to tolerate combination chemotherapy.
本研究的目的是评估每周使用紫杉醇（泰素）治疗晚期食管癌的疗效。
102例晚期食管癌患者接受紫杉醇80mg/m²静脉滴注，每周1次，持续1小时。1个周期定义为4周的治疗。95例患者可评估毒性，86例完成至少2个周期治疗的患者可评估疗效。66例患者为腺癌（66%），65例患者（68%）未接受过化疗。
中位治疗周期数为3个周期（范围1 - 11个周期）。11例患者出现部分缓解（PR）[13%，95%置信区间（CI）6%至20%]。在未接受过化疗的患者中，10例患者出现PR（15%，95%CI 6%至24%），腺癌（8/50，16%）和鳞癌（2/15，13%）的缓解情况相当。接受过化疗的患者缓解有限（1/21，5%）。中位缓解持续时间为172天。中位生存期为274天。治疗耐受性良好，血液学毒性或3/4级毒性最小。
每周使用紫杉醇治疗食管癌的活性有限。中位生存期、适度的活性和治疗耐受性表明，每周使用紫杉醇可能是无法耐受联合化疗患者的一种选择。
