3种化疗方案用于小细胞食管癌的疗效和安全性比较

Comparative of Therapeutic Efficacy and Safety of 3 Chemotherapy Regimens in the Treatment of Small Cell Esophageal Cancer

目的:比较不同化疗方案用于小细胞食管癌的疗效和安全性。方法:回顾性分析58例小细胞食管癌患者资料,按化疗方案的不同分为A组(18例)、B组(26例)和C组(14例)。A组患者静脉滴注顺铂注射液75 mg/m^2,d_(1-3)+紫杉醇注射液175 mg/m^2,d_(1-3)。B组患者静脉滴注顺铂注射液30 mg/m^2,d_(1-3)+依托泊苷注射液100 mg/m^2,d_(1-3)。C组患者静脉滴注酒石酸长春瑞滨注射液25mg/m^2,d_(1-3)+注射用盐酸吉西他滨1 000 mg/m^2,d_(1-3)。3组均以21 d为1个周期,共治疗2个周期。比较3组患者的临床疗效及1、2、3年生存率及Ⅲ~Ⅳ度毒性反应(咳嗽、高热、咳痰、气促、乏力、胸痛、骨髓抑制、消化道反应)发生情况。结果:总有效率及1、2、3年生存率C组>B组>A组,Ⅲ~Ⅳ度咳嗽、高热、咳痰、气促、乏力、胸痛发生率C组<B组<A组,差异均有统计学意义(P<0.05);3组患者Ⅲ~Ⅳ度骨髓抑制、消化道反应发生率比较,差异均无统计学意义(P>0.05)。结论:长春瑞滨联合吉西他滨治疗小细胞食管癌疗效及1、2、3年生存率均显著高于顺铂联合紫杉醇或依托泊苷,且安全性优于顺铂联合紫杉醇或依托泊苷。

OBJECTIVE： To compare therapeutic efficacy and safety of different chemotherapy regimens in the treatment of small cell esophageal cancer. METHODS： In retrospective analysis, 58 patients with small cell esophageal cancer were divided into group A（18 cases）,B（26 cases） and C（14 cases） according to chemotherapy regimens. Group A was given Cisplatin injection 75 mg/m^2 intravenously, d1-3^＋Paclitaxel injection 175 mg/m^2, d1-3. Group B was given Cisplatin injection 30 mg/m^2 intravenously, d1-3＋Et- oposide injection 100 mg/m^2, d1-3. Group C was given Vinorelbine tartrate injection 25 mg/m^2 intravenously, d1-3＋Gemcitabine hydro- chloride for injection 1 000 mg/m^2,d1-3. A treatment course of 3 groups lasted for 21 d, and they all received 2 cycles of treatment. Clinical efficacies, 1, 2, 3-year survival rate and the incidence of III-IV degree toxic reaction （cough, fever, expectoration, short- ness of breath, fatigue, chest pain, bone marrow suppression, gastrointestinal reactions） were compared among 3 groups. RE- SULTS： Total response rate and 1, 2, 3-year survival rate were in descending order： group C〉group B〉group A; the incidence of HI-IV degree cough, fever, expectoration, shortness of breath, fatigue, chest pain were in ascending order： group C＇〈group B〈group A, with statistical significance （P〈0.05）. There was no statistical significance in the incidence of Ill-IV degree myelo- suppression and digestive tract reaction among 3 groups （P〉0.05）. CONCLUSIONS： Therapeutic efficacy and 1,2,3-year survival rate of vinorelbine combined with gemcitabine are significantly higher than those of cisplatin combined with paclitaxel or etoposide with better safety.