周剂量紫杉醇联合顺铂治疗晚期食管癌临床观察

目的观察周剂量紫杉醇（PTX）加顺铂（DDP）联合化疗治疗晚期食管癌的近期疗效和毒副反应。方法晚期食管癌患者48例分为两组，PTX＋DDP组：PTX80mg／m^2静滴第1，8天；顺铂20mg／d静滴第1～5天。5-Fu＋DDP＋CF组：5-Fu500mg／m^2静滴，第1～5天；DDP20mg／d静滴第1～5天，CF100mg／次静滴，在5-Fu前2h内给药第1～5天，21天为1周期，2周期后按UICC标准评价近期疗效和毒副反应。结果PTX＋DDP方案治疗20例食管癌患者有效率为70％；5-Fu＋DDP＋CF方案治疗28例的有效率为50％。前一联合方案总有效率高于后者，有显著性差异（P〈0．05），不良反应也较后者重，但大多数患者能耐受，主要为剂量限制性毒性，表现为Ⅱ～Ⅲ度为主的骨髓抑制。结论周剂量紫杉醇联合顺铂治疗晚期食管癌近期疗效显著，毒副反应小。

Clinical observation of weekly Paclitaxel combined with Cisplatin in the treatment of advanced esophageal carcinoma

Objective To evaluated the efficacy and toxicity of weekly Paclitaxel （PTX） combined with Cisplatin for patients with advanced esophageal carcinoma. Methods 48 patients with Ⅲ-Ⅳ stage carcinoma of esophagus were divided into two groups：20 patients were given Paclitaxel 80 mg/m^2 infusion per week for two weeks, DDP 20mg/d from dl to d5 in PTX＋ DDP group. 28 patients were given 5-Fu 500mg/m^2 from dl to d5,DDP 20mg/d from dl to d5,CF lOOmg/d infusion 2 hours before 5-Fu from dl to d5 in 5-Fu＋DDP＋CF group.After 2 consecutive treatment course,each for 21 days,evaluation of the shortterm efficacy and adverse effects was carried out. Results The response rate of 20 with esophageal cancer treated by PTX＋ DDP was much higher than that of 28 patients treated by 5-Fu＋DDP＋CF （70% VS 50%,P〈0.05）.The adverse effects of the for- mer were more severe than that of the later.The dose-limited toxicity was mild and mainly expressed as bone marrow depression （grade Ⅱ- Ⅲ）. Conclusion Weekly Paclitaxel（PTX）combined with DDP is effective in treating terminal esophageal cancer that has relatively high response rate and tolerable side reactions.