时辰化疗在晚期食管癌治疗中的疗效观察

Effect of chrono-chemotherapy on advanced esophageal cancer

目的:观察时辰化疗在晚期食管癌治疗中的疗效。方法:对85例晚期食管癌患者按信封法随机分为时辰化疗组(42例)和常规化疗组(43例)。时辰化疗组采用在放疗第1、8天分别行紫杉醇(PTX)时辰化疗,给予PTX60mg/m2,静脉滴入3h,每次用药于当天凌晨4∶00开始;顺铂(DDP)20mg/m2,d1～d5,于当天10∶00～22∶00给药,每3～4周为1个周期。常规化疗组PTX和DDP的用量同时辰化疗组,按常规输液时间10∶00左右进行,普通滴速,两组患者每化疗2个周期的间隔时间相同。两组患者化疗的同时给予放射治疗,单次剂量1.8～2Gy,靶区总剂量60～66Gy,6～7周照射。观察两组患者的治疗效果及影像学改善情况。结果:时辰化疗组总有效率为83.3%(35/42),明显高于常规化疗组60.5%(26/43),P<0.05。时辰化疗组毒副反应明显比常规化疗组低,主要为Ⅰ～Ⅱ度。结论:时辰化疗与常规化疗相比是一种高效低毒的治疗晚期食管癌的方法。

OBJECTIVE： To evaluate the effect of ehrono chemotherapy on advanced esophageal cancer. METHODS： Eighty-five eases were randomly divided into two groups which included a chrono chemotherapy group （42 eases） and a routine-chemotherapy group （43 cases）. In the ehrono-ehemotherapy group, PTX 60 mg/m^2,iv drip, d1,d8, at 4am, for 3 hours; DDP 20 mg/m^2 ,iv drip, at 10am-22pm, d1-d5; one cycle for 3--4 weeks. In the routine chemotherapy group, the the dosage of PTX and DDP were the same as the chrono chemotherapy group at 10am. All the patients were also trea ted by the same irradiation therapy with 1.8-2 Gy/fraction to a total dose of 60-66 Gy for 6-7 weeks. RESULTS：The total elective rate in the chrono-ehemotherapy group （83.3%） was significantly higher than that in the routine chemotherapy group, respectively （60.5%）, P〈0.05. The cases of nausea, vomiting, bone marrow and alopecia in the ehrono-chemotherapy group were less than those in the routine-chemotherapy group. CONCLUSION： The chrono-chemotheray has a good effect and low toxicity in the treatment of advanced esophageal cancer.