铂类与氟脲嘧啶联合治疗中晚期食管癌的临床观察

目的评价奈达铂(NDP)+亚叶酸钙(CF)+替加氟方案与顺铂(DDP)+亚叶酸钙(CF)+氟脲嘧啶(5-FU)方案治疗中晚期食管癌的疗效及安全性。方法将42例中晚期食管癌患者随机分为试验组(22例)与对照组(20例),试验组患者采用NDP+CF+替加氟方案化疗,对照组患者采用DDP+CF+5-FU方案化疗,均治疗4个周期后,比较两组的临床疗效和不良反应的发生情况。结果试验组的治疗总有效率显著高于对照组(77.27%vs35.00%,P<0.05)。试验组和对照组的1年和2年生存率分别为81.8%、54.5%和40.0%、30.0%,差异有统计学意义(P<0.05)。两组患者的主要毒副反应为恶心呕吐、腹泻、肾功能异常等,试验组的发生率均明显低于对照组(P<0.05)。结论 NDP+CF+替加氟联合化疗治疗中晚期食管癌的有效率高,且能提高患者的近期生存率,毒副反应较轻,值得临床进一步推广应用。

Clinical Observation on Platinum-based Drugs plus Fluorouracil in Treatment of Middle-advanced Esophageal Carcinoma

Objective To evaluate the efficacy and safety of treatment of nedaplatin （NDP）＋calcium folinate （CF）＋tegafur and treatment of cisplatin （DDP）＋calcium folinate （CF）＋fluorouracil （5-FU） on middle-advanced esophageal cancer. Methods 42 cases of middle-advanced esophageal cancer were randomly divided into the experimental group （22 cases） and the control group （20 cases）. The experimental group was treated with NDP＋CF＋tegafur program, and the control group was treated with DDP＋CF＋5-FU program. All were treated for four cycles, then the clinical efficacy and incidences of adverse reactions were compared between two groups. Results The total efficacy rate of experimental group was significantly higher （77.27%vs 35.00%, P〈0.05） than that of the control group. The 1-and 2-year survival rates were respectively 81.8%and 54.5%in the experimental group, but were respectively 40.0%and 30.0%in the control group;both were sig-nificantly higher in the experimental group （P〈0.05）. The main toxicities in the two groups were nausea and vomiting, di-arrhea, kidney dysfunction etc. The incidence rate of toxicities were significantly lower in the experimental group than that in the control group （P〈0.05）. Conclusion Chemotherapy with NDP, calcium folinate （CF） and fluoride was more effective for middle-advanced esophageal carcinoma. This therapy could enhance the short-term survival rate, and had less adverse reac-tions. Therefore, it was worth of being generalized in clinics.