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[紫杉醇24小时持续输注治疗晚期食管癌]

[A 24-hour continuous infusion of paclitaxel in the treatment of advanced esophageal cancer].

作者信息

Wang Tao, Zhang Shen-feng, Wang Lei

机构信息

Cancer Center, Zaozhuang Municipal Hospital, Zaozhuang 277112, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2010 Jul 27;90(28):1986-8.

Abstract

OBJECTIVE

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/m(2) by a 24-hour continuous infusion, oxaliplatin 130 mg/m(2) 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 cases of squamous cell carcinoma could be evaluated, CR 4, PR 14, SD 4, PD 8, RR 60.0%; Adenocarcinoma CR 0, PR 2, SD 5, PD 4, RR 18.2%. Statistical test show that RR of squamous was higher than that of adenocarcinoma (P < 0.05). The most common toxicity was hematological. Grade III-IV neutropenia was seen in 16 patients (41.4%), alopecia 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.

摘要

目的

评估24小时持续输注紫杉醇联合奥沙利铂治疗晚期食管癌的疗效和安全性。

方法

2008年3月至2009年6月共纳入43例Ⅲ - Ⅳ期晚期食管癌患者。其中鳞状细胞癌32例,腺癌11例。36例患者既往未接受过化疗,7例接受过辅助化疗,4例接受过紫杉类方案。中位年龄56岁。所有患者第1天24小时持续输注紫杉醇175mg/m²,第2天给予奥沙利铂130mg/m²,3周为1个周期。

结果

43例患者共完成130个周期(中位值:3个周期)。41例患者的疗效和安全性可评估。按照WHO标准,完全缓解(CR)4例,部分缓解(PR)16例,病情稳定(SD)9例,疾病进展(PD)12例,有效率(RR)48.7%。30例鳞状细胞癌患者可评估,CR 4例,PR 14例,SD 4例,PD 8例,RR 60.0%;腺癌CR 0例,PR 2例,SD 5例,PD 4例,RR 18.2%。统计学检验显示鳞状细胞癌的RR高于腺癌(P<0.05)。最常见的毒性反应为血液学毒性。16例患者出现Ⅲ - Ⅳ度中性粒细胞减少(41.4%),脱发60.9%,呕吐26.8%,神经病变22%,肌痛19.5%。多数为Ⅰ - Ⅱ度。

结论

24小时持续输注紫杉醇联合奥沙利铂治疗晚期食管癌疗效显著。所有毒性反应耐受性良好。因此该方案可考虑作为晚期食管癌的主要治疗方案。

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