吉西他滨联合氟尿嘧啶、亚叶酸钙治疗老年晚期食管癌的临床观察

目的：探讨吉西他滨（GEM）联合氟尿嘧啶（5-FU）、亚叶酸钙（LV）组成的GLF方案治疗老年晚期食管癌的客观疗效和安全性。方法：32例老年晚期食管癌患者,采用GLF方案化疗,GEM800mg/m^2,第1、8天,静脉滴注30分钟,CF200mg,第1～5天,5-FU350mg/m^2,第1～5天,21天为1周期。2周期后评价疗效。结果：29例患者可评价疗效,共完成周期数92个,其中完全缓解1例,部分缓解12例,稳定8例,进展8例,总有效率（CR＋PR）44.8%,疾病控制率（CR＋PR＋SD）72.4%,中位疾病进展时间5.2个月,中位生存期9.5个月（2.0～14.6个月）。主要毒性反应为Ⅰ～Ⅱ度血液性毒性,包括白细胞下降（41.4%）、贫血（51.7%）、血小板下降（58.6%）,Ⅲ～Ⅳ度非血液毒性,包括乏力（24.1%）以及腹泻（10.3%）,均可耐受。结论：吉西他滨联合氟尿嘧啶、亚叶酸钙治疗老年晚期食管癌疗效肯定,安全性较好,患者可耐受。

Gemcitabine combined with 5-FU/CF in elderly patients with advanced esophageal cancer

Objective：To evaluate the efficacy and toxicity of gemcitabine combined with 5-FU/CF in elderly patients with advanced esophageal cancer.Methods：Thirty-two elderly patients with advanced esophageal cancer were treated with gemcitabine 800mg/m^2 on days 1,8,CF 200mg on d1-5 and 5-FU 350mg/m^2 on d1-5.The regimen was repeated every 21 days.All patients received two or more cycles.Results：Twenty-nine patients were evaluated after 2 to 6 cycles of chemotherapy.One case achieved CR and 12 cases achieved PR.The overall response rate（ORR）was 44.8% and the disease control rate（DCR） was 72.4%.The median time to progression（TTP） was 5.2 months,and median overal survival（OS） was 9.5 months.The most common toxicities grade 1-2 were neutropenia（41.4%）,anaemia（51.7%）,thrombocytopenia（58.6%）,as well as grade 3-4 fatigue（24.1%） and diarrhea（10.3%）.These toxicities were well-tolerated.Conclusion：The combination of gemcitabine and 5-FU/CF was active and well tolerated as a first line regimen in the elderly with advanced esophageal cancer.