Font A, Arellano A, Fernández-Llamazares J, Casas D, Boix J, Cardenal J, Margelí M, Manzano J L, Abad A, Rosell R
Medical Oncology Service, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.
Clin Transl Oncol. 2007 Mar;9(3):177-82. doi: 10.1007/s12094-007-0032-5.
To evaluate the efficacy and tolerability of weekly docetaxel concurrent with radiotherapy in inoperable oesophageal cancer patients.
Thirty-four oesophageal cancer patients with co-morbid medical conditions, locally advanced tumours (T4) or advanced age (older than 75 years) received docetaxel (20 mg/m2 weekly) plus concurrent radiotherapy (2 Gy daily, to a total dose of 66 Gy). Twenty-two patients (64%) were stage III, 19 of whom had T4 tumours.
Twenty-seven patients (79%) completed the planned chemoradiotherapy treatment. Nine patients (26%) achieved a complete response and 8 (24%) achieved a partial response, for an overall response rate of 50%. Median survival was 6 months, and 1-year survival was 35%. Patients with T4 tumours had significantly shorter survival than other patients: 5 months for T4 tumours vs. 11 months for T1-3 (p=0.04). Grade 3-4 oesophagitis occurred in 6 patients (17%). There were two treatment-related deaths due to radiation pneumonitis.
Docetaxel plus concurrent radiotherapy is active in poor-prognosis oesophageal cancer patients, with a lower incidence of severe oesophagitis than with cisplatin-based chemoradiotherapy regimens. This schedule can be considered, especially in patients with non-T4 tumours who are not candidates for oesophageal resection.
评估每周多西他赛联合放疗在无法手术的食管癌患者中的疗效和耐受性。
34例合并内科疾病、局部晚期肿瘤（T4）或高龄（75岁以上）的食管癌患者接受多西他赛（每周20mg/m²）联合同步放疗（每日2Gy，总剂量66Gy）。22例患者（64%）为Ⅲ期，其中19例有T4肿瘤。
27例患者（79%）完成了计划的放化疗治疗。9例患者（26%）达到完全缓解，8例（24%）达到部分缓解，总缓解率为50%。中位生存期为6个月，1年生存率为35%。T4肿瘤患者的生存期明显短于其他患者：T4肿瘤患者为5个月，而T1 - 3患者为11个月（p = 0.04）。6例患者（17%）发生3 - 4级食管炎。有2例因放射性肺炎导致的治疗相关死亡。
多西他赛联合同步放疗对预后较差的食管癌患者有效，与基于顺铂的放化疗方案相比，严重食管炎的发生率较低。尤其对于不适合食管切除术的非T4肿瘤患者，可考虑采用该方案。
