Petrasch S, Welt A, Reinacher A, Graeven U, König M, Schmiegel W
Department of Internal Medicine, Knappschaftskrankenhaus, Ruhr University of Bochum, Germany.
Br J Cancer. 1998 Aug;78(4):511-4. doi: 10.1038/bjc.1998.524.
Single-agent therapy with paclitaxel is effective against both squamous cell carcinoma and adenocarcinoma of the oesophagus. However, only limited data are available on the combination of paclitaxel with other cytotoxic drugs in this entity. Patients with unresectable stage III, recurrent or metastatic tumours were treated in a multicentre setting with paclitaxel 90 mg m(-2) given over 3 h intravenously, followed by cisplatin 50 mg m(-2). The courses were repeated every 14 days. Twenty patients with squamous cell carcinoma or adenocarcinoma of the oesophagus were evaluable for response. The overall remission rate was 40% (8/20), including 15% (3/20) clinically complete responses. Clinical benefit response, defined as relief of dysphagia and/or significant gain in weight, was achieved in 70% of the patients. Neutropenia of CTC grade 3 occurred only in 10% of the patients; no grade 4 neutropenia and no severe thrombocytopenia was encountered. CTC grade 4 neurotoxicity was seen in 5% of patients. Cisplatin/paclitaxel administered every 14 days, was effective in patients with poor prognosis oesophageal cancer and toxicity was acceptable.
紫杉醇单药治疗对食管鳞状细胞癌和腺癌均有效。然而,关于紫杉醇与其他细胞毒性药物联合用于该疾病的资料有限。对不可切除的Ⅲ期、复发或转移性肿瘤患者在多中心进行治疗,静脉输注紫杉醇90mg/m²,持续3小时,随后给予顺铂50mg/m²。疗程每14天重复一次。20例食管鳞状细胞癌或腺癌患者可评估疗效。总缓解率为40%(8/20),包括15%(3/20)的临床完全缓解。70%的患者实现了临床获益反应,定义为吞咽困难缓解和/或体重显著增加。仅10%的患者出现3级中性粒细胞减少;未出现4级中性粒细胞减少和严重血小板减少。5%的患者出现4级神经毒性。每14天给予顺铂/紫杉醇治疗,对预后较差的食管癌患者有效,且毒性可接受。