TP与PF方案同期放疗治疗食管癌的疗效对比

目的观察紫杉醇加顺铂化疗同步放疗与顺铂加氟尿嘧啶化疗同步放疗治疗中晚期食管癌的疗效和不良反应。方法将72例食管癌患者随机分成紫杉醇加顺铂化疗(TP组)同步放疗组和顺铂加氟尿嘧啶化疗(PF组)同步放疗组各36例。TP组采用紫杉醇:135～165 mg/m²,d1,顺铂：20～30 mg/m²,d1～3,21天一个周期,共3～4周期。PF组采用顺铂：20～30 mg/m²,d1～3,氟尿嘧啶：500 mg/m²,d1～5,21天一个周期,共3～4周期。两组放疗方法相同,总剂量GTV：(60～66)Gy/(30～33)F。结果两组近期疗效比较差异无统计学意义(P=0.691)。TP组和PF组的1年和3年生存率：TP组分别为86%和53%;PF组分别为83%和50%。两组比较差异无统计学意义(χ²=0.148,P=0.701)。不良反应的比较差异无统计学意义。结论紫杉醇加顺铂化疗同步放疗与顺铂加氟尿嘧啶化疗同步放疗食管癌相比疗效相当且不增加不良反应。

Comparison on Therapeutic Efficacy of Combined TP or PF with Concurrent Radiotherapy to Advanced Esophageal Carcinoma

Objective To investigate the therapeutic efficacy and adverse reactions of combined Cisplatin and Paclitaxel(TP regimen) or Fluorouracil(PF regimen) with the synchronous radiotherapy to the advanced esophageal carcinoma.Methods Seventy-two cases with esophageal carcinoma were randomly assigned in TPregimen and PF regimen groups.All the patients received conventional radiotherapy at a total dose of 60～66 Gy(in 30～33 fractions).In TPregimen group,the patients received intravenous infusion of Paclitaxel(135～165 mg/m2) for 3h on day 1 and DDP(20～30 mg/m2 daily) on days 1～3,with every 21 days as one cycle.PF regimen consisted of cisplatin(20～30 mg/m2) on days 1～3 and of continuous intravenous infusion of fluorouracil(500 mg/m2) for 5 days,with every 21 days as one cycle.Results No significant differences were found in the survival rates of 1 and 3 years between the TP regimen group(86% and 53%,respectively) and PF regimen group(83% and 50%,respectively)(χ2=0.148,P=0.701),The same result was also found in the short-term effect.No marked differences of the incidence of all adverse reactions including radiotherapy-induced esophagitis,gastrointestinal reactions and myelosuppression were observed between the two groups(P>0.05).Conclusion Compared with the treatment of esophageal carcinoma using PF regimen,the treatment of esophgeal carcinoma using TP regimen shows the closed therapy efficacy and doesn′t increase the adverse reactions.