奈达铂与顺铂对食管癌同步放化疗治疗的不良反应比较

目的对比分析含奈达铂（捷佰舒、NDP）的方案和含顺铂（诺欣、DDP）的方案在同步放化疗治疗食管癌的不良反应。方法我科2007年12月-2009年3月收治的食管癌患者52例，随机分为两组，NF组（NDP＋5-Fu＋放疗）24例，DF组（DDP＋5-Fu＋放疗）28例。两组均常规分割放疗，2.0Gy／次，术后患者总剂量50Gy／25次／35天，未手术的患者64Gy／320／44天，化疗在放疗的第一天开始，NF组为NDP60mg／m^2·d1、2＋5-Fu500mg／m^2·d1-5；DF组为25mg／m^2·d1-4＋5-Fu500mg／m^1·d1-5。两组均28天为一个疗程，共2个疗程。结果NF组的主要不良反应，如恶心呕吐、肾功能损害发生率明显低于DF组（P〈0．05），白细胞下降无显著性差异（P〉0．05），血小板下降NF组高于DF组（P〈0．05）。结论NDP＋5-Fu联合放疗治疗食管癌术后患者是安全的，不良反应易于耐受，特别适合老年人使用，疗效比较有待进一步随访。

Side effects contrasting of nedaplatin plus 5-Fu and cisplatin plus 5-Fu combined with synchronous radiotherapy on esophageal cancer

Objective To compare the adverse effects of uedaplatin plus 5 - Fu and cisplatin plus 5 - Fu combined with synchronous radiotherapy on esophageal cancer. Methods From December 2007 to March 2009,52 cases with esophageal carcinoma were randomly divided into two groups： concurrent chemoradiotherapy with NDP and 5 -Fu（the NF group, n = 24 ）and synchronous chemoradiotherapy with DDP and 5 - Fu （the DF group, n = 28）. The patients in these two groups were treated with conventional fractionated radiotherapy at 2.0 Gy/f,the postoperative with a total dose of 50 Gy/25Fx/35d and the unoperated with a total dose of 64 Gy/32Fx/ 44d. Chemotherapy regime was delivered on the first day of radiotherapy. The chemotherapy in the NF group consisted of 2 cycles of NDP at 60mg/（m^2 ·d）on day 1 to 2 plus 5 - Fu at 500 mg（m^2 · d）on day 1 to 5 every 4weeks ,and the DF group consisted of 2cycles of DDP at 25 mg（ m^2 · d） on day 1 to 4 plus 5 - Fu at 500 mg（ m^2· d） on day 1 to 5 every 4weeks. Results The incidence of major adverse effects in the NF group such as nausea, vomiting and response rate of nephrotoxicity were lower compared to that in the DF group （ P 〈 0.05 ）. There was no significant difference between two groups in the incidence of leukopenia（P 〉0.05）. There was a higher thrombocytopenia response rate in NF group than that in DF group, with a significant difference between the groups（P 〈 0. 05 ）. Conclusions NDP ＋ 5 - Fu combined with radiotherapy can safely treat esophageal cancer and side effects is tolerant, so it is fit to the olds especially. However, the efficacy of the two groups is needed for further study.