5-FU按时辰低剂量节律式持续输注治疗食管癌的临床观察

Low-dose metronomic chronochemotherapy by continuous infusion of fluorouracil for esophageal cancer

目的:评价5-氟尿嘧啶(5-FU)按时辰低剂量节律式持续输注(CIV)治疗中晚期食管癌的近期疗效及耐受性。方法:将食管癌患者分为CIV治疗组(实验组)和常规化疗组(对照组)。实验组34例:顺铂(DDP)10mg,d1～d5,d8～d12;5-FU375mg,CIV,22∶00～10∶00,d1～d14,或联合紫杉醇90mg,d1,d8。对照组36例:DDP每周期总量100～120mg,分4～5d;醛氢叶酸100mg,d1～d5(5-FU前);5-FU750mg,CIV,d1～d5;紫杉醇用法同实验组。每21d为1个周期,两个周期后评价疗效及耐受性。结果:可评价患者70例,总有效率(CR+PR)为44.3%(31/70)。实验组化疗复治有效率为48.0%(12/25),高于对照组的13.3%(2/15),χ2=5.98,P<0.05。实验组KPS评分增加率为52.9%(18/34),亦高于对照组的30.6%(11/36),P=0.023。结论:5-FU按时辰低剂量节律式持续输注联合低剂量DDP治疗中晚期食管癌疗效确切,且耐受性好,尤其对于化疗复治者更具优势,值得推广应用。

OBJECTIVE： To evaluate the efficacy and tolerability of low-dose 5-FU metronomic chronochemotherapy by continuous infusion （CIV） in patients with medium and advanced esophageal cancer. METHODS： The patients with esophageal cancer were divided into low dose metronomic chronochemotherapy by CIV group（experimental group） and conventional chemotherapy group （control group）. The regimen of experimental group（34） consisted of cisplatin （DDP） 10 rag, dl-d5, d8-d12 and 5-FU 375 rag, CIV, 22 ： 00-10：00, d1-d14 , or combining paclitaxel 90 mg, d1 , d8. The chemotherapy of control group（36） contained： the DDP total dose of 100-120 mg per cycle, 4-5 days, leucovorin 100 mg, d1 d5 （before 5-FU） and 5 FU 750 mg, CIV, d1-d5, with the same use of paclitaxel in experimental group. The regimens were repeated every 21 days in each group. The efficacy and tolerance were evaluated after two cycles. RESULTS： All 70 cases could be evaluated. The over- all response rate was 44.3% （31/70）. The response rate of re-treated chemotherapy patients in experimental group and control group were 48.0% （12/25） and 13.3%（2/15）, respectively （X^2 =5.98, P〈0.05）. The KPS score increased rate in experimental and control group were 52. 9% （18/34） and 30.6% （11/36） respectively（P=0. 023）. CONCLUSION： The regimen of experimental group in the treatment of medium and advanced esophageal cancer is effective, well tolerated and worth applied, particularly in those patients whose chemotherapy are re-treated.