大剂量顺铂、氟脲嘧啶、平阳霉素治疗晚期食管癌临床观察

High-dose Chemotherapy with Cisplatin 5-fluorouracil and Pingyangmycin in Advanced Esophageal Carcinoma

目的 观察大剂量顺铂 (DDP)、氟脲嘧啶 ( 5 Fu)和平阳霉素 (PYM )联合化疗方案治疗晚期食管癌的疗效和安全性。方法 对 5 3例不能手术切除和无根治性放疗指征的晚期食管鳞癌患者 ,采用 2组不同剂量的方案进行联合化疗。随机分为 2组 ,治疗组每周期顺铂 12 0mg/m2 、5 Fu 15 0 0mg/m2 和PYM 3 6mg/m2 ,对照组剂量分别是 60mg/m2 、10 5 0mg/m2 和 2 4mg/m2 。结果 治疗组有效率 (CR +PR ) 61.5 % ,高于对照组 ( 2 9.6% ) ,有显著性差异 (P <0 .0 5 )。全组病人均有不同程度的消化道反应、骨髓毒性及脱发 ,治疗组较对照组明显 ,主要为恶心、呕吐 ,但患者均能耐受。结论 适当强化DDP、5 Fu和PYM剂量将提高食管癌的疗效。

Objective To evaluate efficacy and safety of high dose chemotherapy with cisplatin(DDP)、5 fluorouracil(5 Fu) and pingyangmycin(PYM) in esophageal carcinoma.Methods fifty three patients with advanced esophagus carcinoma were treated with DDP, 5 Fu and PYM.The patients were randomized to high dose group and control group.In high dose group 26 patients were given DDP 120 mg/m 2,5 Fu 1 500 mg/m 2 and PYM 36 mg/m 2 every cycle.27 patients in the control group were given DDP 60 mg/m 2,5 Fu 1 050 mg/m 2 and PYM 24 mg/m 2 per cycle.Results The response(CR+PR) of high dose group and control group was 61.5% and 29.6%,respectively( P <0.05).Toxicity was tolerable and consisted principally of nausea and vomiting.Conclusion This regimen is effective for advanced esophageal squamous cell carcinoma.