依托泊苷胶囊维持治疗晚期食管小细胞癌临床疗效观察

摘要

Objective:To observe the clinical efficacy of etoposide for maintenance treatment of extensive primary small cell esophageal cancer(ED-PSEC).Methods:A total of 33 patients diagnosed as ED-PSEC received 4 cycles of standard chemotherapy, and obtained disease control.Then they were randomly divided into 2 groups, including,the treatment group(17) and the control group(16).The treatment group received etoposide 50 mg/ d orally, 1 ～21 d,with an interval of 1 week until disease progression,and the control group received medical observation and regular review, until recurrence or metastasis.Regular observations and follow-up were performed in both groups.Results:The median progression-free survival(PFS) for treatment group and control group was 10.1 months and 6.4 months, respectively(P ＜ 0.05).The 1-year survival rates were 64.7％ and 48.5％ (P =0.05).The side effects of treatment group included bone marrow suppression, gastrointestinal reactions, which can be relieved after drug withdrawal and symptomatic support therapy.Conclusion:These data showed that etoposide for maintenance treatment of extensive primary small cell esophageal cancer(ED-PSEC) can prolong PFS and improve the overall survival.%目的:观察依托泊苷胶囊维持治疗晚期食管小细胞癌的疗效.方法:33例经4周期含依托泊苷二联方案化疗后病情稳定或完全缓解的食管小细胞癌患者,随机分为观察组(17例)和对照组(16例).观察组继续给予依托泊苷胶囊维持治疗,口服每日50 mg,连续服用21天,停药1周,q28 d,对照组停药定期复查.两组患者每2个月复查,直至病变进展.结果:观察组与对照组中位无病生存时间(PFS)分别为10.1个月和6.4个月,两组比较差异有统计学意义(P=O.001 ＜0.05);1年生存率(OS)分别为64.7％和48.5％,两组比较差异无统计学意义(P=0.05).两组患者生活质量统计学未见差异,观察组不良反应主要为骨髓抑制、消化道反应,经对症处理后缓解.结论:依托泊苷胶囊维持治疗可以延长广泛期食管小细胞癌患者的无病生存期,有进一步延长生存时间的趋势.