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局部晚期食管癌患者新辅助同步放化疗联合卡培他滨和奥沙利铂

Neoadjuvant concurrent chemoradiotherapy with capecitabine and oxaliplatin in patients with locally advanced esophegeal cancer.

机构信息

Department of Clinical Oncology and Nuclear Medicine, Mansoura University, Mansoura, Egypt.

出版信息

Med Oncol. 2012 Sep;29(3):1693-8. doi: 10.1007/s12032-011-0001-2. Epub 2011 Jun 26.

Abstract

Evaluation of the feasibility and efficacy of neoadjuvant concurrent chemoradiotherapy (CRT) with capecitabine and oxaliplatin in patients with locally advanced esophageal cancer. Forty-two patients were eligible for the study. The chemotherapy during CRT consisted of two cycles of intravenous oxaliplatin of 120 mg/m(2) on day 1 and oral capecitabine 825 mg/m(2) twice daily on days 1-14 at 3-week intervals. The radiotherapy (1.8 Gy/fraction/day to a total dose of 45 Gy) was delivered to the primary tumor site and regional lymph node. All patients completed the planned treatment. Overall clinical response rate was 54.8% with complete response in 16.7% while pathological response rate was 38%. Anemia was the commonest hematologic toxicity (52.3%) with grade 3 in 4.7%, and esophagitis was the commonest non-hematologic toxicity 59.5% with grade 3 and 4 in 9.5%. No treatment-related death was observed. After a median follow-up duration of 19 months, the 2-year survival rate was 42%, median survival time was 20 months (95%CI: 13.802-26.198), while 2-year progression-free survival (PFS) rate was 32.5% with median PFS time of 15 months (95%CI: 10.042-19.958). Neoadjuvant concurrent CRT with capecitabine and oxaliplatin was found to be well tolerated and effective in patients with locally advanced esophageal cancer; however, these results should be further evaluated in a phase III study.

摘要

评估卡培他滨和奥沙利铂新辅助同步放化疗治疗局部晚期食管癌的可行性和疗效。42 例患者符合研究条件。CRT 期间的化疗包括静脉注射奥沙利铂 120mg/m2,第 1 天,口服卡培他滨 825mg/m2,每日 2 次,每 3 周 1 个周期,共 2 个周期。放疗(1.8Gy/分次/天,总剂量 45Gy)用于原发肿瘤部位和区域淋巴结。所有患者均完成了计划治疗。总体临床缓解率为 54.8%,完全缓解率为 16.7%,病理缓解率为 38%。贫血是最常见的血液学毒性(52.3%),3 级占 4.7%,食管炎是最常见的非血液学毒性(59.5%),3 级和 4 级占 9.5%。未观察到与治疗相关的死亡。中位随访 19 个月后,2 年生存率为 42%,中位生存时间为 20 个月(95%CI:13.802-26.198),2 年无进展生存率(PFS)为 32.5%,中位 PFS 时间为 15 个月(95%CI:10.042-19.958)。卡培他滨和奥沙利铂新辅助同步放化疗在局部晚期食管癌患者中具有良好的耐受性和疗效,但这些结果尚需在 III 期研究中进一步评估。

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