多西他赛联合顺铂方案新辅助治疗局部晚期食管鳞癌的临床研究

目的分析比较多西他赛联合顺铂方案(TP)与氟尿嘧啶联合顺铂方案(PF)新辅助治疗局部晚期食管鳞癌的有效性及安全性。方法收集自2010年6月至2013年3月在我院肿瘤内科和胸心外科住院新辅助化疗的局部晚期食管鳞癌患者94例,其中TP方案组42例(DTX 75 mg/m2,静滴d1,DDP 20 mg/m2,静滴d1^d3)和PF组52例(5-FU 1000 mg/m2,静滴d1d3)和PF组52例(5-FU 1000 mg/m2,静滴d1^d5;DDP 20 mg/m2,静滴d1d5;DDP 20 mg/m2,静滴d1^d3,q4周)组。化疗3周期后评价疗效及毒副反应。结果全部入组病例均可评价近期疗效和毒副反应。TP组患者的近期有效率明显高于PF组(P<0.05);然而疾病控制率相似,无统计学意义(P=0.344);两组化疗方案的3d3,q4周)组。化疗3周期后评价疗效及毒副反应。结果全部入组病例均可评价近期疗效和毒副反应。TP组患者的近期有效率明显高于PF组(P<0.05);然而疾病控制率相似,无统计学意义(P=0.344);两组化疗方案的3⁴级毒副反应方面比较,毒副作用均可耐受,恶心呕吐、过敏、乏力、腹泻的34级毒副反应方面比较,毒副作用均可耐受,恶心呕吐、过敏、乏力、腹泻的3⁴级不良反应发生率两组比较差异无统计学意义(P>0.05)。骨髓抑制、神经毒性及肌痛差异具有显著性(P<0.05)。结论在局部晚期食管鳞癌新辅助化疗中,TF方案与PF方案比较,具有更好的近期有效率,但有更高的毒副反应,经过及时处理后PF方案可具有较好的耐受性。

The Clinical Research of Docetaxel Plus Cisplatin for the Treatment of Local Advanced Esophageal Squamous Cell Carcinoma with New Adjuvant Chemotherapy

ObjectiveTo compare and analyze the efficacy and safety of docetaxel plus cisplatin and 5-FU plus cisplatin for local advanced esophageal squamous cell carcinoma with new adjuvant chemotherapy.Methods collect 92 patients with local advanced esophageal squamous cell carcinoma treated with new adjuvant chemotherapy in chest surgery and Oncology from june 2010 to march 2013, 42 patients with docetaxel plus cisplatin（TP）（DTX 75 mg/m2,iv,d1,DDP 20 mg/m2,iv,d1∽d3,q3w;）,52 patients treated with 5-FU plus cisplatin（PF）（DDP 20 mg/m2,iv,d1∽d3,5-FU1000 mg/m2, d1∽d5,iv）.The efficacy and the toxicity were evaluated after three cycles.Results All the cases could be evaluated efficacy and toxicity, the group TP had higher recent effective rate（RR） than group PF, while there was no statistical significance about the disease control rate（DCR） between the two groups, Toxicity of two groups were tolerable, for the 3-4 degree toxicity, there was no statistical significance about vomit, anaphylaxis, weak, Diarrhea（P〉0.05）. While the incidence rate of hypoleucocytosis, neurotoxin, muscular pain were higher in group TP than in group PF with significance difference.Conclusion The patients with local advanced esophageal squamous cell carcinoma treated with new adjuvant chemotherapy, group TP had better recent effective rate, but higher toxicity, toxicity of groups TP were tolerable if intervention acticivity.