DLF方案加羟基喜树碱治疗晚期食管癌的临床观察

Clinical Observation on Esophageal Cancer Patients Treated with DLF Scheme Plus Hydrocamptothecin

目的 :寻找晚期食管癌的有效治疗方法。 方法 :自 1995年 3月至 1998年 4月以DLF方案 (顺铂、醛氢叶酸、5 -氟脲嘧啶 )加与不加羟基喜树碱 (HCPT)治疗晚期食管癌。结果 :治疗组有效率 6 8.7% ,而对照组为 43.3% ,差异显著 (P <0 .0 5 )。主要毒副作用为纳差、恶心或呕吐 ,其发生率为 85 .3% ,但多为Ⅰ～Ⅱ级 ;白细胞下降在治疗组和对照组分别为 82 .4%和 6 3.4% ,差异不具有统计学意义 (P >0 .0 5 ) ,Ⅲ～Ⅳ级白细胞下降少见 ;血小板下降两组分别为 35 .3%和 10 % ,差异显著 (P <0 .0 5 ) ,但亦多为Ⅰ～Ⅱ级 ;口腔粘膜炎和腹痛、腹泻等副作用也比较轻。结论 :我们认为DLFH方案治疗晚期食管癌安全有效 ,是一种可行的方案。

Objective: To search an effective management for esophageal cancer patients. Methods: From March 1995 to April 1998, sixty-four cases of esophageal cancer were randomly divided into two groups: the treatment group recieved a combined therapy of cisplatin, leucovorin, 5-fluorouracil plus hydrocamptothecin (DLFH) and the control group recieved cisplatin,leucovorin and 5-fluorouracil (DLF) without hydrocamptothecin. The efficacy and toxicity in these two groups were evaluated after two courses of treatment. Results: The overall response rate of the treatment group was 68.7% , while the control group was 43.3% with significant difference ( P <0.05). The major toxicities included anorexia, nausea, vomiting, leucopenia and reduced platelete count, but it was tolerable in most of the patients. Conclusion: The combination regimen of DLFH is effective and safe for esophageal cancer patients.