经内镜局部化学治疗晚期食管癌胃癌疗效分析

The effect of local chemotherapy for advanced esophageal carcinoma and gastric carcinoma patients with endoscope

目的探讨氟尿嘧啶+顺铂(5-FU+DDP)局部化学治疗食管癌、胃癌的近期疗效和副作用。方法将确诊晚期食管癌、胃癌患者86例随机分为两组,A组48例应用5-FU250mg+DDP20mg经内镜分点注射于肿瘤表面和周边,B组38例应用5-FU500mg+DDP40mg静脉滴注,内镜下观察对肿瘤的直接影响及对食管内梗阻的影响。结果A组和B组有效率分别为60.42%、39.47%(P<0.05),中位生存期分别为9.8个月和7.6个月。主要副反应为白细胞减少和胃肠道反应,无治疗相关死亡病例。结论5-FU+DDP联合局部化疗晚期食管癌胃癌有效,可改善患者的生活质量,延长生存期。

Objective To investigate curative effect and side effect of combination of 5-FU and DDP for treating advanced esophageal carcinoma and gastric carcinoma patients with endoscope. Methods Eighty-six patients with advanced esophageal cancer or gastric cancer verified by pathology were randomly divided into 2 groups. The patients in treatment group （A） consisting of 48 patients were treated by local chemotherapy in which 5-FU 250 mg and DDP 20 mg were directly injected into tumor with endoscope. In the control group （B） consisting of 38 patients, 5-FU 500 mg and DDP 40 mg were given intravenously. The influences on the carcinoma size and esophageal obstruction were observed with endoscope. Result The effective rate in Group A was significantly higher than in Group B （ 60.42% vs 39.47%, P 〈 0.05）, and the median survival time of the patients in Group A was 9.8 months while in Group B 7.6 months. The main side effects were neutropenia and digestive tract reaction, and there was no treatment-related death. Conclusion The combined chemotherapy with endoscope regimen based on 5-FU and DDP shows a good curative effect and low toxicity in treatment of advanced esophageal carcinoma and gastric carcinoma patients, it can improve the quality of life and prolong the patient＇s survival time.