奥沙利铂联合5-氟尿嘧啶、醛氢叶酸钙治疗晚期食管癌

Oxaliplatin Plus 5-fluorouracil,and Folinic Acid(FOLFOX-4) in Treating Patients with Advanced Esophageal Carcinoma

【目的】观察奥沙利铂（L-OHP）联合5-氟尿嘧啶（5-FU）、醛氢叶酸钙（FOLFOX-4）治疗晚期食管癌的疗效和不良反应。【方法】采用FOLFOX-4方案治疗31例晚期食管癌患者。2周1个周期，至少4个周期。【结果】31例中，完全缓解1例（3％），部分缓解13例（42％），稳定9例（29％），进展8例（26％）。总有效率为45％，中位生存期7．5个月（5．5～13．5个月），中位缓解期4．5个月（2～8个月），中位肿瘤进展时间6个月（3～11个月）。最常见的不良反应为神经感觉障碍、消化道反应及骨髓抑制，多为Ⅰ～Ⅱ度，无Ⅳ度不良反应发生，无治疗相关性死亡。【结论】FOLFOX-4方案是治疗晚期食管癌安全有效的化疗方案。

[Objective]To evaluate the efficacy and tolerability of the combination of oxaliplatin, 5-fluorouracil and folinic acid（FOLFOX-4） in treating patients with advanced esophageal cancer. [Methods]Thirty-one patients with unresectable, recurrent or metastatic esophageal adenocarcinoma or squamous cell carcinoma were enrolled. Patients received a 2-day infusion of L-OHP plus 5-FU and FA, every 2 weeks a an cycle for at least 4 cycles. [Results]Of the thirty-one patients enrolled, the overall response rate was 45 % ,with complete and partial response rates of 3% and 42%, respectively. The median overall survival was 7.5 months, and the median response duration 4.5 months, and the median time to tumor progress 6 months. The regimen was given without any grade IV toxicity observed, but grade 1 or 2 cumulative peripheral neuropathy, neutropenia, anaemia, diarrhea, nausea, and emesis had occurred. [Conclusion]The combination of oxaliplatin, fluorouracil, and folinic acid shows significant anti-tumor activity and a favorable toxicity profile in patients with metastatic carcinoma of the esophagus.