适时导向化疗治疗晚期食管癌的临床研究

目的对比观察PPF方案的适时导向化疗与常规导向化疗的疗效及毒副作用.方法将80例晚期食管癌患者随机分为适时导向化疗组(A组)与常规导向化疗组(B组),靶向化疗药物为复方氟尿嘧啶脂质体.A组PPF方案的具体用法:平阳霉素(PYM)8mg/次,第1、3、5、7天,上午10时肌内注射;复方氟尿嘧啶脂质体:第1天80mg,第2、3、4、5天120mg,均加入生理盐水500ml中,晨2～6时静脉滴注;顺铂(PDD):50mg/m2,第6、7天水化、利尿,15～17时静脉滴注,21d为1个周期.结果 A组40例,总有效率为77.5%(31/40);B组40例,总有效率为55.0%(22/40),两组相比差异有统计学意义(P=0.034).A组有5例获得完全缓解,B组无1例完全缓解.恶心呕吐的发生率:A组为52.5%(21/40),B组为85.0%(34/40),两组相比差异有统计学意义(P＜0.01):白细胞下降发生率:A组为30.0%(12/40),B组为65.0%(26/40),两组相比差异有统计学意义(P＜0.01):A组腹泻、口腔膜炎及静脉炎的发生例数均较B组少,A组无肝肾毒性发生,而B组有一定的肝肾毒性发生.结论用PPF方案适时导向化疗治疗晚期食管癌疗效高,毒副作用小,明显优于常规导向化疗,值得临床推广应用.

CHRONO-TARGETING CHEMOTHERAPY IN TREATING LATE ESOPHAGEAL CANCER

Objective To contrast the curative effects of chrono-targeting chemotherapy and routine-targeting chemotherapy.Methods 80 cases of late esophagel cancer were divided into Group A treated with chrono-targeting chemotharapy and Group B treated with routine-targeting chemotherapy.The target-chemotherapy drug was compound 5-fluorouracil (Co-5-Fu).Group A was treated:PYM was used 8mg/time at 10 each morning in the 1st,3rd,5th and 7th day;Co-5-Fu was used,80mg for the 1st day,120mg for the 2nd,3rd,4th and 5th day with 500ml of NS at 2 to 6 in each morning;PDD was used,50mg/m~2 in intravenous drips for 15 to 17 hours a day in the 6th and 7th days at 10 each day,21 days a course.Results the total effective rates of Group A and Group B were 77.5% and 55.0% respectively(P=0.034).Comple remissions were got in 5 cases in Group A,but not in Group B.The occurrence rate of nausea and vomiting in Group A and Group B were 52.5% and 85.0% respectively (P<0.01).The rates of reduction of white cells in Group A and Group B were 30.0% and 65.0% respectively (P<0.01).Diarrhea,oral mucositis and phlebitis occurred less in Group A than Group B.Hepatic-renal toxity occurred to some degree in Group B,but not in Group A.Conclusion Chrono-targeting chemotherapy has proved to produce better curative effects than the routine-targeting chemotherapy,therfore,deserves to be widely used.