多西他赛联合顺铂或氟尿嘧啶治疗转移或复发的老年食管鳞癌患者的疗效比较

Comparative study of docetaxel combined with cisplatin and docetaxel combined with fluorouracil regimen for elderly patients with metastasis or recurrence of esophageal squamous cell carcinoma

目的比较多西他赛联合顺铂（TP）与多西他赛联合氟尿嘧啶（TF）2种方案治疗转移或复发的老年食管鳞癌患者的疗效及不良反应。方法 90例老年晚期食管鳞癌患者,随机分为2组,其中TP方案化疗组46例,TF方案化疗组44例,21 d为1周期,每例患者完成4~6个周期化疗,并随访。每2个周期后评价疗效,每周期评价不良反应。结果 TP组与TF组有效率（RR）分别为41.3%、34.1%,疾病控制率（DCR）分别为73.9%、70.5%,中位进展时间（TTP）分别为5.0月、4.6月,中位生存期分别为9.5月、8.2月,2组间比较差异均无统计学意义（P〉0.05）。主要不良反应为骨髓抑制及消化道反应,TP方案恶心呕吐发生率较TF方案高（P〈0.05）,TF方案腹泻发生率较TP方案高（P〈0.05）。结论在转移或复发的老年食管鳞癌治疗中,TF与TP疗效相近,不良反应可耐受,可作为有效的化疗方案应用于临床。

Objective To evaluate clinical efficacy and adverse reactions of docetaxel combined with cisplatin（ TP）or Docetaxel combined with fluorouracil（ TF） chemotherapy for the elderly patients with metastasis or recurrence of esophageal squamous cell carcinoma（ ESCC）. Methods Ninety elderly cases with advanced ESCC were randomly divided into two groups with 46 cases in TP group and 44 cases in TF group. TP group received docetanel combined with TP,and TF group received docetaxel combined with TF. Twenty-one days were a cycle. Each patient completed 4-6 cycles of chemotherapy and was followed up. The efficacy was evaluated after every two cycles and the toxicity was assessed after each cycle. Results The total efficiency rate（ RR） of TP group and TF group was 41. 3% and 34. 1%,the disease control rate（ DCR） was 73. 9% and 70. 5%,the median time to progression（ TTP） was 5. 0 and 4. 6 months,the median survival time（ MST） was 9. 5 and 8. 2 months,respectively,with no significant difference between two groups（ P〉0. 05）.The incidence rate of nausea and vomiting in TP group was higher than that in TF group（ P〈0. 05）,while the incidence rate of diarrhea in TF group was higher than that in TP group（ P〈0. 05）. Conclusions In the therapy of elderly patients with metastasis or recurrence of ESCC,TF regimen is as effective as TP regimen,and adverse reactions could be tolerated.Therefore,as an effective regimen,TF could be applied into clinical chemotherapy.