The Brown University Oncology Group, Providence, Rhode Island, USA.
Am J Clin Oncol. 2012 Feb;35(1):64-7. doi: 10.1097/COC.0b013e318201a126.
To evaluate the pathologic complete response (CR) rate and safety of paclitaxel poliglumex (PPX), cisplatin, and concurrent radiation for patients with esophageal cancer.
Patients with adenocarcinoma or squamous cell carcinoma of the esophagus or gastroesophageal junction with no evidence of distant metastasis received PPX (50 mg/m(2)/wk) and cisplatin (25 mg/m(2)/wk) for 6 weeks with 50.4 Gy concurrent radiation. Six to eight weeks after completion of chemoradiotherapy, patients underwent surgical resection.
Forty patients were enrolled, 37 patients with adenocarcinoma and 3 patients with squamous cell cancer. The treatment-related grade 3 nonhematologic toxicities included esophagitis (7%), nausea (7%), and fatigue (5%). Three patients with clinical endoscopic CR (2 with squamous cell cancer) refused surgery. Twelve of the remaining 37 patients (32%) had a pathologic CR. The 12 patients with pathologic CR all had adenocarcinoma.
PPX, cisplatin, and concurrent radiation are well tolerated, easily administered regimen for esophageal cancer with a low incidence of significant esophagitis and a high pathologic CR rate consistent with the preclinical data of PPX and radiation.
评估紫杉醇聚谷氨酸（PPX）、顺铂联合放疗治疗食管癌患者的病理完全缓解（CR）率和安全性。
入组患者为无远处转移证据的食管腺癌或食管胃交界部鳞癌患者，接受 PPX（50mg/m²/周）和顺铂（25mg/m²/周）治疗 6 周，同时给予 50.4Gy 的放疗。放化疗结束后 6-8 周，患者行手术切除。
共入组 40 例患者，其中 37 例为腺癌，3 例为鳞癌。治疗相关的 3 级非血液学毒性包括食管炎（7%）、恶心（7%）和疲劳（5%）。3 例临床内镜 CR（2 例为鳞癌）患者拒绝手术。37 例患者中，12 例（32%）病理完全缓解。这 12 例病理完全缓解的患者均为腺癌。
PPX、顺铂联合放疗治疗食管癌患者耐受性良好，给药方便，食管炎发生率低，病理 CR 率高，与 PPX 和放疗的临床前数据一致。
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