Neoadjuvant Paclitaxel Poliglumex, Cisplatin, and Radiation for Esophageal Cancer A Phase 2 Trial
Neoadjuvant Paclitaxel Poliglumex, Cisplatin, and Radiation for Esophageal Cancer A Phase 2 Trial
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DOI：
10.1097/coc.0b013e318201a126
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发表时间：
2012-02-01
影响因子：
2.6
通讯作者：
Safran, Howard
中科院分区：
文献类型：
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作者：
Dipetrillo, Thomas;Suntharalingam, Mohan;Safran, Howard
目的：评价紫杉醇聚葡胺（PPX）、顺铂和同步放射治疗食管癌患者的病理完全缓解（CR）率和安全性。患者和方法：无远处转移证据的食管或胃食管连接部腺癌或鳞状细胞癌患者接受PPX治疗顺铂（25 mg/m2/wk）和顺铂（50 mg/m2/wk）联合放疗6周，放疗剂量50.4戈伊。结果：共纳入40例患者，其中腺癌37例，鳞癌3例。治疗相关的3级非血液学毒性包括食管炎（7%）、恶心（7%）和疲乏（5%）。3例临床内镜CR患者（2例鳞状细胞癌）拒绝手术。其余37例患者中有12例（32%）达到病理学CR。12例病理学完全缓解患者均为腺癌。结论：PPX、顺铂联合放疗是一种耐受性好、易于实施的食管癌治疗方案，显著食管炎发生率低，病理学完全缓解率高，与PPX联合放疗的临床前数据一致。
Purpose: To evaluate the pathologic complete response (CR) rate and safety of paclitaxel poliglumex (PPX), cisplatin, and concurrent radiation for patients with esophageal cancer.Patients and Methods: 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.Results: 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.Conclusion: 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.