作者：杨佳丽，杨伟雄，刘振国，傅夏宇，张水深，曾博，程超

单位：中山大学附属第一医院 胸外科，广东 广州 510000

Authors: Yang Jiali, YangWeixiong, Liu Zhenguo, Fu Xiayu, Zhang Shuishen, Zeng Bo, Cheng Chao

Unit: Department of Thoracic Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510000, Guangdong, China

摘要：

目的 对比紫杉醇脂质体和多西他赛用于潜在可手术切除的局部进展期食管鳞癌新辅助化疗的疗效和安全性。方法 回顾性分析2014年9月到2019年4月中山大学附属第一医院胸外科使用紫杉醇脂质体联合铂类或多西他赛联合铂类行新辅助化疗的42例潜在可手术切除的局部进展期食管鳞癌患者的临床资料,按照用药类别分为紫杉醇脂质体组(n=28)和多西他赛组(n=14),观察两组在近期、远期疗效及围术期安全性方面的差异。结果 紫杉醇脂质体组和多西他赛组客观缓解率(objective response rate, ORR)和食管切除术完成率差异无统计学意义(分别为53.6%比50.0%、92.9%比85.7%, P>0.05)。手术群体中,两组R0切除率、肿瘤退缩评分、无进展生存期(progression free survival, PFS)、总体生存期(overall survival, OS)、手术时间、术中出血量及常见术后并发症发生率差异无统计学意义(P>0.05)。两组均未出现围术期死亡病例。结论 紫杉醇脂质体用于食管鳞癌新辅助化疗的疗效和安全性与多西他赛无差异,可作为食管鳞癌新辅助化疗中紫杉烷类药物的一种选择。

关键词：食管鳞状细胞癌; 新辅助化疗; 紫杉醇脂质体; 多西他赛;

Abstract：

Objective To compare the efficacy and safety of paclitaxel liposome and docetaxel in neoadjuvant chemotherapy for potentially resectable locally advanced esophageal squamous cell carcinoma. Methods The clinical data of 42 patients with potentially resectable locally advanced esophageal squamous cell carcinoma who received neoadjuvant chemotherapy with paclitaxel liposome combined with platinum or docetaxel combined with platinum in the Department of Thoracic Surgery, First Affiliated Hospital of Sun Yat-sen University from September 2014 to April 2019 were retrospectively analyzed. The differences in short-term effect, long-term effect and perioperative safety between the two groups were observed. Results There was no significant difference in objective response rate (ORR)(53.6% vs 50.0%, P>0.05)and esophagectomy completion rate(92.9% vs 85.7%, P>0.05)between paclitaxel liposome group and docetaxel group. Among the patients who received surgical treatment subsequently, there was no significant difference in R0 resection rate, tumor regression score, progression free survival (PFS), overall survival (OS), operation time, intraoperative blood loss and the incidence of common postoperative complications between the two groups. There was no perioperative death in both groups. Conclusions There is no difference in efficacy and safety between paclitaxel liposome and docetaxel in neoadjuvant chemotherapy of esophageal squamous cell carcinoma. Paclitaxel liposome can be used as a choice of taxanes in neoadjuvant chemotherapy of esophageal squamous cell carcinoma.

Key Words: Esophageal squamous cell carcinoma; Neoadjuvant chemotherapy; Paclitaxel liposome; Docetaxel