大剂量醛氢叶酸加5-FU持续滴注联合DDP治疗晚期食管癌及生存分析  

High-dose-folinic acid,5-fluorouracil bolus and continuous infusion 48 hours combined with cisplatin in treatment of advanced esophageal carcinoma

作　　者：江艺[1] 邱希辉[1] 陈志明[1] 林丹霞[1] 张盛奇[1] 

机构地区：[1]汕头大学医学院附属肿瘤医院内科,广东汕头515041

出　　处：《现代肿瘤医学》2007年第1期50-52,共3页Journal of Modern Oncology

基　　金：汕头市重点科技计划项目(编号:汕府科[2002]86号)

摘　　要：目的：评价大剂量醛氢叶酸加5氟尿嘧啶（5-FU）持续48h滴注联合顺铂（DDP）方案治晚期食管癌的客观疗效、毒副反应并进行生存分析，探索晚期食管癌较合理治疗方案及相关预后因素。方法：对人选的晚期食管癌病人采用大剂量醛氢叶酸（200mg／m^2）＋5FU（3．0g/m^2）持续48h滴注联合顺铂方案进行治疗。结果：共48例病人入选，中位年龄52．0岁，48例均可进行疗效及毒副作用评价。完全缓解（CR）9例，部份缓解（PR）20例，稳定（NC）17例，进展（PD）2例，总有效率为60．42％。主要的毒副反应为恶心呕吐、口腔粘膜炎、骨髓抑制及脱发等，大多数为Ⅰ～Ⅱ度反应，经常规对症治疗后见好转，未见治疗相关死亡。全组48例患者中位生存期为10．00个月，95％的可信区间为7．51～12．49。晚期食管癌治疗前如KPS评分＜80或已出现内脏器官转移，提示预后较差，从治疗中获益将较少。治疗前功能状态及病变或转移部位是影响预后的相关因素，两者的P值分别为0和0．048。结论：大剂量醛氢叶酸＋5FU持续48h滴注联合顺铂方案治疗晚期食管癌疗效好，且毒副反应轻，可作为晚期食管癌化疗的标准一线方案。Objective： To assess the anti - tumor efficacy and safety of high - dose - folinic acid plus 5 - fluorouracil bolus and continuous infusion 48 hours combined with cisplatin in treating advanced esophageal carcinoma（AEC）. Methods： The patients with AEC were treated with high - dose - folinic acid plus 5 - fluorouracil bolus and continuous infusion 48 hours combined with cisplatin. Results：Total of 48 patients with AEC were included in the study, middle age was 52 ,and 48 patients were assessable for response and toxicity. There were 9 complete respone, 20 partial respone, 17 no changes and 2 progressive disease in this series with total response rate of 60.42%. The main side effects included nausea and vomiting, mucositis, bone marrow suppression and alopecia. Other side effects were uncommon. After a median follow - up of 9.00 months , the overall median survival was 10.00 months（95% CI, 7.51 to 12.49）. Karnofsky score 〈 80 before chemotherapy or viscera metastasis indicated poor prognosis. Conclusion： High - dose - folinic acid plus 5 - fluorouracil bolus and continuous infusion 48 hours combined with cisplatin is a safe and effective therapy , and may be recommended as first - line standard regimen for AEC.

关 键 词：晚期食管癌 化学疗法 大剂量醛氢叶酸 DDP 5-FU 

分 类 号：R735.1[医药卫生—肿瘤]