紫杉醇联合DDP与奈达铂联合5-FU治疗晚期食管癌的临床观察

Clinical observation of paclitaxel plus cisplatin and nedaplatin plus 5-fluorouracil in treatment of advanced esophageal carcinoma

目的:比较紫杉醇联合DDP与奈达铂联合5-FU治疗晚期食管癌的临床疗效及不良反应。方法:48例晚期食管癌随机分组,23例进入TP组(紫杉醇联合DDP),25例进入NF组(奈达铂联合5-FU)。TP组:PTX135-175mg/m2,静脉滴注3小时,d1,DDP20mg/m2,静脉滴注,d1-5;NF组化疗方案:NDP80-100mg/m2,静脉滴注2小时,d1,5-FU500mg/m2,d1-5;每3周为1个周期,至少完成2个周期。结果:TP组和NF组的有效率分别为52.5%和48.0%,两组无统计学差异(P>0.05)。TP组不良反应较NF组明显严重,TP组主要为脱发、中性粒细胞减少、消化道反应、周围神经毒性,NF组主要为消化道反应、中性粒细胞减少。结论:TP方案与NF方案治疗晚期食管癌疗效相似,不良反应可以耐受,均可以用于晚期食管癌的治疗。

Objective ：To evaluate the response and toxicity of paclitaxel（PTX） plus cisplatin（DDP） and nedaplatin（NDP） plus 5- fluorouracil （5 -FU ） for the patients with advanced esophageal carcinoma. Methods：Fortyeight patients with advanced esophageal carcinoma were divided randomly into two groups. TP group composed of 23 cases were treated with PTX plus DDP, and NF group including 25 cases were treated with NDP plus 5 - FU. Patients in TP group were given PTX 135 - 175mg/m^2 by 3 - hour infusion on d1 and DDP 20mg/m^2 d1-5. Patients in NF group were given NDP 80 -100mg/m^2 by 2 -hour infusion on d1 and 5 -FU 500mg/m^2 d1-5. Every 3 weeks as one cycle for at least 2 cycles was given. Results：The response rate was 52.5% in TP group,and 48.0% in NF group. Statistically no significant difference between the two groups （ P 〉 0. 05 ）. The toxicity in TP group was more severe than NF group. The main toxicities of TP group were alopecia, neutropenia, gastrointestinal reaction, peripheral neurotoxicity. The main toxicities of NF group were gastrointestinal reaction and neutropenia. Conclusion： The response rate of PTX/DDP regimen for patients with advanced esophageal carcinoma is similar to NDP/5 - FU regimen and its adverse toxicity is tolerable. Either of regimen can be used in treatment of advanced esophageal carcinoma.