周剂量紫杉醇联合FP方案治疗晚期食管癌的临床观察

Effects of weekly paclitaxel combining with 5-Fluorouracil plus cisplatin on advanced esophageal carcinoma

目的探讨周剂量紫杉醇联合5-氟脲嘧啶+顺铂方案化疗治疗晚期食管癌的疗效及不良反应。方法 65例晚期食管癌患者,随机分为2组。观察组(32例):紫杉醇60 mg/m^2,静脉滴注3 h,每周1次,连用3周;5-氟脲嘧啶500 mg/(m^2·d)、顺铂20 mg/(m^2·d)静脉滴入,d1～d5,每4周重复。对照组(33例):5-氟脲嘧啶500 mg/(m^2·d)、顺铂20 mg/(m^2·d)静脉滴入,d1～d5,每3周重复。均化疗3～6周期。结果观察组和对照组的有效率分别为56.3%和30.3%,差异有统计学意义。中位无进展缓解期(TTP)观察组6.8个月,对照组4.6个月;1年生存率观察组为31.3%,对照组21.2%,差异无统计学意义。两组不良反应均以骨髓抑制及消化道反应为主,差异无统计学意义。重度骨髓抑制发生率不高。结论周剂量紫杉醇联合FP方案化疗治疗晚期食管癌较单用FP方案近期有效率提高,不良反应未见明显增加,显示一定的临床优越性。

Objective To evaluate the efficacy and safety of weekly paclitaxel combining with 5 - Fluorouracil plus cisplatin in the treatment of advanced esophageal carcinoma. Methods Sixty - five cases of advanced esophageal cancer were divided randomly into two groups. 32 patients in the treatment group were treated by weekly Paclitaxel （60 mg/m^2 ）, intravenous dripping for three hours, continue for three times. And combining with intravenous dripping for 5 - Fluorouracil （500 mg/m^2） plus cisplatin （20 mg/m^2） from the first day to the fifth day, every four weeks repeated. 33 patients in the control group were treated by intravenous dripping for 5 -Fluorouracil（500 mg/m^2） plus cisplatin（ 20 mg/m^2） from the first day to the fifth day, every three weeks repeated. All cases were treated for three to six cycles. Results The total response rates in the treatment group and the control group were 56.3% and 30.3% respectively. There were statistically significant difference between the two groups. The median TI＇P in the two groups were 6.8 months and 4.6 months respectively. The 1 - year survival rates in the two groups were 31.3% and 21.2% respectively. There were no statistically significant difference in the two groups. The major toxicities were myelo - suppression and gastrointestinal reaction. There were no statistically significant difference in the two groups. The myelo - suppression was similar in the two groups. Conclusion It shows that the response rate of weekly Paclitaxel combining with 5 - Fluorouracil plus cisplatin in the treatment of advanced esophageal carcinoma was higher. The toxicities were similar between the two groups.