周剂量紫杉醇联合LFP方案治疗晚期食管癌的临床观察

The Clinical Observation of Weekly Paclitaxel Combined with LFP for Treating Advanced Esophageal Carcinoma

目的 评价周剂量紫杉醇（PTX）联合氟脲嘧啶（5-Fu）、顺铂（DDP）和醛氢叶酸（CF）组成PLFP方案治疗晚期食管癌的临床疗效和毒副反应。方法 16例Ⅲ、Ⅳ期晚期食管癌，给予周剂量PTX＋LFP（CF＋5-Fu＋DDP），即PTX 80 mg/m^2，iv gtt qw，连续2周；DDP 80 mg/m^2，iv gtt，d3-5；5-Fu 500 mg/m^2，iv gtt，d1-5；CF100 mg/次，iv gtt，在5-Fu前2 h内给药，d1-5，21 d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 全组16例，全都可评价疗效，总有效率56.3%，11例初治组有效率为63.6%，其中CR 1例。5例复治组有效率为40%。毒副反应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 周剂量紫杉醇联合氟脲嘧啶、顺铂和醛氢叶酸组成的PLFP方案可能是治疗晚期食管癌较好的化疗方案，值得进一步观察。

Objective To evaluate the efficacy and toxicity of weekly paelitaxel（PTX） combined with 5-fluorouracil（5-Fu） , DDP and CF as alternative chemotherapy for patients with advanced esophageal carcinoma. Methods Sixteen patients were enrolled in the study. Each was treated as follows： PTX 80 mg/m^2 infusion per week for two weeks; DDP 80 mg/m^2 infusion , d1-3 or d1-5 ; 5-Fu 500 mg/m^2 infusion, d1-5 ; CF 100 mg/d infusion 2 hours before 5-Fu infusion, d1- 5; After 2 consecutive treatment course, each for 21 days, evaluation of the short-term efficacy and adverse effects was carried out. Results The overall response rate were 43.8% . The response rates of 11 patients in primary treatment were 63.6% （ 1 ease CR） and that of relapse treatment was 40% . The dose-limited toxicity was mild and mainly expressed as bone marrow depression（grade Ⅱ -Ⅲ ）. Conclusions Weekly paclitaxel（PTX） combined with 5-fluorouracil（5-Fu） , DDP and CF as alternative chemotherapy is encouraging for patients with advanced esophageal carcinoma.