奈达铂、氟尿嘧啶联合紫杉类药物治疗晚期食管癌近期疗效观察

目的　评价以奈达铂（ＮＤＰ）和氟尿嘧啶（５-ＦＵ）方案（ＮＦ方案）为基础联合紫杉类药物一线治疗晚期食管癌的近期疗效和安全性。方法　回顾性分析２００５年至２０１０年收治的３０２例经病理确诊的晚期食管癌临床资料。ＮＦ方案组９０例，具体为：ＮＤＰ８０ｍｇ／ｍ２静滴，第１天；５-ＦＵ５００ｍｇ／ｍ２静滴，第１～５天。联合治疗组２１２例，在ＮＦ方案基础上分别联合：（１）紫杉醇（ＰＴＸ）１３５ｍｇ／ｍ２静滴，第１天；（２）多西紫杉醇（ＤＯＣ）７５ｍｇ／ｍ２静滴，第１天。所有方案２１天为１个周期，２个周期后评价疗效，所有患者完成２～６个周期化疗，每周期评价毒副反应。结果　３０２例均可评价疗效，ＮＦ方案组和联合治疗组有效率分别为６４.４％（５８／９０）和６２.７％（１３３／２１２），疾病控制率分别为８７.８％（７９／９０）和９２.５％（１９６／２１２），两组差异均无统计学意义（Ｐ＞０.０５）。ＮＦ方案组３～４级白细胞减少、血小板减少的发生率分别为１０.０％（９／９０）、４.４％（４／９０），未出现消化道反应及肝功能损害；联合治疗组３～４级白细胞减少、血小板减少的发生率分别为６.６％（１４／２１２）、３.８％（８／２１２），２～３级消化道反应为４.２％（９／２１２），１～２级肝功能损害为１.９％（９／２１２）。结论　ＮＦ方案或联合紫杉类药物治疗晚期食管癌近期疗效肯定，但联合紫杉类药物未能明显提高近期疗效，且出现较高的消化道反应及肝功能损害，ＮＦ方案仍建议为晚期食管癌的首选方案。

Clinical study of nedaplatin and fluorouracil in combination with taxanes in the treatment of advanced esophageal cancer

Objective To evaluate the efficacy and toxicity of nedaplatin(NDP) and fluorouracil(5-FU) regimen(NF regimen) in combination with taxanes in patients with advanced esophageal cancer. Methods We retrospectively reviewed the clinical data of 302 patients with advanced esophageal cancer from 2005 to 2010 confirmed by histopathology.Of the 302 patients,90 cases were treated with NF regimen only:NDP(80mg/m2 d1),5-FU(500mg/m2 d1-d5),every 21 days was a cycle;212 were treated with NDP and 5-FU based regimen in com...