奈达铂联合替加氟治疗晚期食管癌

Nedaplatin combined with tegafur in the treatment for advanced esophageal cancer

目的评价奈达铂（NDP）联合替加氟（FT-207）治疗晚期食管癌的疗效和毒副反应。方法65例晚期食管癌患者中，初次化疗患者27例，术后接受辅助化疗38例。NDP20mg／m^2，静脉滴注2h，第1—5天；FT-207500mg／m^2，静脉滴注8h，第1～5天；21d为1个周期。结果65例患者共完成193个化疗周期，其中可评价疗效的患者63例。27例初次化疗的患者中，CR6例，PR16例，有效率为81．5％；36例复治的患者中，CR6例，PR10例，有效率为44．4％。所有患者的中位疾病进展时间（TTP）为5．6个月，中位生存时间为9．3个月，1年生存率为24．9％。临床毒副反应为恶心、呕吐，患者均能耐受。63例可评价毒副反应的患者中，有2例（3．2％）出现Ⅲ～Ⅳ度中性粒细胞降低。结论NDP联合FT-207对晚期食管癌疗效肯定，毒副反应轻，可作为治疗晚期食管癌的主要治疗方案。

Objective To investigate the efficacy and toxicity of nedaplatin combined with tegafur in the treatment for patients with advanced esophageal cancer. Methods Among the 65 patients with advanced esophageal cancer, 27 had no history of prior chemotherapy and the other 38 had ever received postoperative adjuvant chemotherapy before. The median age of those cases was 58.0 years. Nedaplafin was given dally by intravenous infusion at a dose of 20 mg/m^2 for 2 hours and tegafur at a dose of 500 mg/m^2 for 8 hours on D1- D5, every 21 days as a cycle. Results 193 cycles of chemotherapy were accomplished in the 65 patients, and 63 patients were evaluable for response evaluation. Of 27 patients with no prior history of chemotherapy, 6 achieved complete response and 16 partial response, with a response rate （CR ＋ PR） of 81.5%. Among the 36 patients who had ever received postoperative adjuvant chemotherapy, 6 obtained complete response and 10 partial response with a response rate （CR ＋ PR） of 44.4%. The overall median time to tumor progression in this series was 5.6 months. The overall median actuarial survival was 9.3 months, and the one-year survival rate was 24.9%. Nausea and vomiting were the major toxicities, but were mild and well tolerable. Grade 3 to 4 neutropenia was only observed in two patients （3.2%）. Conclusion The regimen of nedaplatin combined with tegafur is effective and tolerable for the treatment of advanced esophageal cancer.