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[目的]探讨在食管癌同期放化疗中多西紫杉醇固定周剂量时奈达铂(NDP)的周最大耐受剂量(MTD),并观察其不良反应。[方法]共入选20例初治食管鳞癌患者,采用三维适形放疗方法,DT:60～64Gy/30～32f,42～44d,同步化疗方案固定多西紫杉醇剂量20mg/w,共6w,NDP采用周剂量递增方法,起始剂量12mg/m2,递增剂量为6 mg/m2。剂量限制性毒性(DLT)定义为≥3级不良反应,出现DLT的前一剂量即为MTD。[结果]NDP 24mg/m2剂量水平时共有2例患者发生3～4级的DLT;NDP 18mg/m2、多西紫杉醇20mg即为MTD。主要不良反应为放射性食管炎、放射性肺炎、乏力和骨髓抑制。[结论]食管癌同步放化疗中固定多西紫杉醇20mg每周剂量时奈达铂每周最大耐受剂量为 18mg/m2。
[Objective] To investigate the weekly maximum tolerated dose (MTD) of docetaxel in esophageal cancer with concurrent weekly radiotherapy and chemotherapy and to observe its adverse reactions. [Methods] 20 patients with newly diagnosed esophageal squamous cell carcinoma were treated with three-dimensional conformal radiotherapy (DT: 60-64Gy / 30-32f, 42-44d). The dose of docetaxel was 20mg / NDP weekly dose increment method, the initial dose of 12mg / m2, increasing dose of 6 mg / m2. Dose-limiting toxicities (DLTs) were defined as grade 3 adverse events and the first dose of DLT was MTD. [Results] There were 2 patients with grade 3-4 DLT at the dose of 24mg / m2 NDP; MTD was induced by 18mg / m2 NDP and docetaxel 20mg. The main adverse reactions were radiation esophagitis, radiation pneumonitis, fatigue and myelosuppression. [Conclusion] The weekly maximum tolerated dose of nedaplatin is 18mg / m2 when paclitaxel is fixed at 20mg weekly in esophageal cancer with concurrent chemoradiotherapy.