奥沙利铂联合替加氟辅助治疗食管鳞状细胞癌

Oxaliplatin combined with tegafur as adjuvant chemotherapy for esophageal squamous cell carcinoma

目的观察奥沙利铂（L-OHP）联合替加氟（FT-207）辅助治疗食管鳞状细胞癌根治性切除术后患者的生存率。方法郑州大学附属肿瘤医院2008年1月至2010年12月住院治疗的126例食管鳞状细胞癌手术患者入组,其中单纯手术组92例,L-OHP联合FT-207辅助化疗组34例;Ⅰ期21例,Ⅱ期88例,Ⅲ期17例。化疗方案：术后2-4周开始化疗,L-OHP 130 g／m2,第1天,静脉滴注;FT-207 500 mg／m2,每天1次,连用5 d,静脉滴注。所有患者常规应用5-羟色胺 （5-HT）受体拮抗剂预防性止吐治疗。21 d为1个周期,每例患者至少化疗2个周期。结果单纯手术组1、3年生存率分别为93.5 %、75.0 %,辅助化疗组1、3年生存率分别为97.1 %、76.2 %,两组患者1、3年生存率相比差异无统计学意义（P=0.590）。另外,不同性别、年龄、肿瘤部位、大体类型、分化程度、有无淋巴结转移和分期等亚组人群分析,单纯手术组与L-OHP联合FT-207辅助化疗组的生存率差异均无统计学意义。Cox回归模型分析结果显示,年龄、分化程度、分期是影响生存率的独立因素。结论L-OHP联合FT-207术后辅助化疗没有提高食管鳞状细胞癌根治性手术切除患者的1、3年生存率。食管癌术后辅助化疗目前尚缺乏有效方案,有待今后进一步深入研究。

ObjectiveTo investigate the survival benefit of patients with esophageal squamous cell carcinomas who recieved postoperative chemotherapy of tegafur combined with FT-207 radiotherapy. MethodsData from 126 patients with esophageal squamous were analyzed who undergone radical resection from January 2008 to December 2010, consisting of 92 patients underwent surgery alone and 34 patients took oxaliplatin combined with tegafur postoperatively （oxaliplatin 130 g/m2, d1, tegafur 500 mg/m2, d1-5, 21 d for a cycle, every patient received at least two cycles）. ResultsThe 1-year survival rate and 3-year survival rate was 93.5 % and 75.0 % in the surgery alone group, was 97.1 % and 76.2 % in the surgery plus postoperative chemotherapy （P = 0.590）. There was no significant differences in survival in the two groups, even with Cox-regression multivariate analysis and with stratifications of gender, age, tumor location, degree of cell differentiation, invasion depth, lymphatic metastasis and TNM stage. ConclusionPostoperative adjuvant chemotherapy with oxaliplatin combined with tegafur has not significantly improve the survival rate of patients with esophageal squamous cell carcinomas undergoing radical resection. It is still lack of an effective project for postoperative adjuvant chemotherapy for esophageal cancer, and it is necessary for further study.