奈达铂和氟尿嘧啶联合放疗治疗中晚期食管癌临床观察

Clinical observation of nedaplatin and fluorouracil with radiotherapy in treatment of middle and advanced esophageal cancers

目的:观察奈达铂和氟尿嘧啶化疗联合放疗治疗中晚期食管癌的近期疗效及不良反应。方法:60例患者随机分为治疗组和对照组,每组各30例,先采用静脉化疗2周期,后给予局部放射治疗,同时化疗2周期。治疗组:奈达铂(NDP)80mg/m2,d1;亚叶酸钙(CF)70mg/(m2.d),d1-5;氟尿嘧啶(5-FU)500mg/(m2.d),d1-5;对照组:顺铂(PDD)25mg/(m2.d),d1-3;亚叶酸钙和氟尿嘧啶用法同治疗组。21天为1周期。放疗采用外照射,每次2Gy,每周5次,总照射剂量为60-70Gy。结果:治疗组:CR 15例,PR 12例,SD 3例,PD 0例,有效率(RR)为90.0%(27/30);对照组:CR 14例,PR 12例,SD 4例,PD 0例,有效率(RR)86.7%(26/30),两组有效率相当(P>0.05);对照组呕吐的发生率明显高于治疗组(P<0.05)。骨髓抑制,白细胞减少治疗组为50.0%,对照组为16.7%(P<0.05)。血小板减少治疗组为16.7%,对照组为0(P<0.05)。结论:奈达铂和氟尿嘧啶化疗联合放疗治疗中晚期食管癌,疗效确切,毒副作用可以耐受。

Objective：To observe the efficacy and adverse reaction of nedaplatin and fluorouracil with radiotherapy in treatment of middle and advanced esophageal cancers.Methods： All 60 cases were randomly devided into two groups,each group 30 cases.At first,the vein chemotherapy was used for two periods,and then applied the local radiotherapy,the vein chemotherapy for two periods.Treating group： NDP 80mg/m2,d1;CF 70mg/（m2·d）,d1-5;5-FU 500mg/（m2·d）,d1-5;Control group： PDD 25mg/（m2·d）,d1-3;CF and 5-FU was the same with treating group.21 days for one cycle.The radiotherapy： five times a week,2 Gy once,total irradiation dosage 60-70 Gy.Results：In treating group：15 patients were CR,12 patients were PR,3 patients were SD,0 patient PD,the RR was 90.0%（27/30）;In control group,14 patients were CR,12 patients were PR,4 patients were SD,0 patient PD,the RR was 86.7%（26/30）;The RR was similar in two groups（P0.05）;The rate of vomiting in the control group was higher than the treating group（P0.05）.The rate of bone marrow suppression ：the decrease of WBC was 50.0% in treating group and 16.7% in control group（P0.05）,decrease of platelet was 16.7% in treating group and 0 in control group（P0.05）.Conclusion：Nedaplatin and fluorouracil with radiotherapy in treatment of middle and advanced esophageal cancers is effective and safe.