目的 探討多西他賽聯(lián)合順鉑治療同步放療中晚期食管癌的臨床療效和安全性.方法 選取2009年3月—2011年3月上海市閔行區(qū)中心醫(yī)院收治的中晚期食管癌患者112例,隨機(jī)分為對(duì)照組(56例)和治療組(56例).兩組患者均行放射治療,對(duì)照組在放療基礎(chǔ)上靜脈滴注順鉑注射液25 mg/m²,1～3 d;靜脈滴注氟尿嘧啶注射液500 mg/m²,1～5 d.治療組靜脈滴注多西他賽注射液20 mg/m²,1～3 d;靜脈滴注順鉑注射液25 mg/m²,1～3 d.兩種方案均自放療第1天開始,連續(xù)治療21 d為1個(gè)療程.治療2個(gè)療程后評(píng)價(jià)近期臨床療效,同時(shí)隨訪24～48個(gè)月,計(jì)算患者生存率和無進(jìn)展生存率.結(jié)果 治療組和對(duì)照組的有效率分別為91.07%、80.36%,兩組有效率比較差異有統(tǒng)計(jì)學(xué)意義(P<0.01).治療組2、3、4年生存率明顯高于對(duì)照組(P<0.05).治療組Ⅲ～Ⅳ度惡心、嘔吐、放射性食管炎、口腔炎的發(fā)生例數(shù)明顯低于對(duì)照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05).結(jié)論 多西他賽聯(lián)合順鉑治療同步放療中晚期食管癌具有較好的臨床療效,對(duì)遠(yuǎn)期生存率也具有較好的效果,值得臨床應(yīng)用.

Objective To explore the clinical effect and safety of docetaxel combined with cisplatin in treatment of advanced esophageal cancer with synchronous radiotherapy. Methods Patients with advanced esophageal cancer who came to the Central Hospital of Minhang District in Shanghai from March 2009 to March 2011 (112 cases) were randomly divided into control (56 cases) and treatment (56 cases) groups. Patients in two groups were given radiotherapy. The patients in the control group were iv administered with Cisplatin Injection (25 mg/m²) for 1 — 3 d and Fluorouracil Injection (500 mg/m²) for 1 — 5 d on the basis of radiotherapy. The patients in the control group were iv administered with Docetaxel Injection (20 mg/m²) for 1 — 3 d and Cisplatin Injection (25 mg/m²) for 1 — 3 d. Two treatment options started since the first day of radiotherapy, and continuous treatment of 21 d was as one course. Short-term clinical effect was evaluated, while followed up for 24 — 48 months, and the survival rate and progression-free survival rate were calculated. Results The efficacies in the treatment and control groups were 91.07% and 80.36%, respectively, and there were differences between the two groups (P < 0.01). Survival rates of 2, 3, 4 years in the treatment group were obviously higher than those of the control group (P < 0.05). The occurrence of Ⅲ -Ⅳ nausea, vomiting, radioactive esophagitis, and stomatitis in the treatment group was significantly lower than that in the control group, and there were differences between the two groups (P < 0.05). Conclusion Docetaxel combined with cisplatin has good clinical effect in treatment of advanced esophageal cancer with synchronous radiotherapy, and also has a good effect for long-term survival, which is worthy of clinical application.