放疗联合多西他赛+奈达铂(DN)或顺铂+氟尿嘧啶(PF)方案治疗局部晚期食管癌的临床分析  

Clinical Analysis of Radiotherapy combined with Docetaxel+Nedaplatin (DN) or Cisplatin plus Fluorouracil (PF) in the Treatment of Locally Advanced Esophageal Cancer

作　　者：柯柳杨[1] 黄白云[1] 

机构地区：[1]广东省农垦中心医院,广东湛江524002

出　　处：《中国医药指南》2013年第23期13-14,16,共3页Guide of China Medicine

摘　　要：目的比较多西他赛联合奈达铂(DN)与顺铂联合氟尿嘧啶(PF)新辅助化疗后同期放化疗治疗局部晚期食管癌的急性毒副反应及近期疗效。方法分析本院82例接受DN方案或PF方案新辅助化疗后同期放化疗的局部晚期食管癌患者的临床资料,所有病例均经病理学检查确诊,随机分为DN组和PF组。分别接受DN或PF方案新辅助化疗2个周期,然后两组患者均接受适型放疗及DN或PF方案的2个周期的同步化疗。评价两组患者的急性毒副反应和近期疗效。结果 DN组和PF组3级以上恶心呕吐发生率分别为19.5%和46.3%,差异有统计学显著性意义(P=0.018)。3～4度中性粒细胞数减少发生率分别为48.8%和26.8%,差异无统计学意义(P=0.068)。两组的客观缓解率无统计学意义(P=0.737)。结论 DN新辅助化疗后同步放化疗是局部晚期食管癌的有效治疗手段,近期疗效与PF方案联合放疗相当,但在降低恶心呕吐等毒副反应方面,比PF方案有较明显优势.Objectives To evaluate the acute toxicity and efficacy of neoadjuvant chemotherapy followed by concurrent chemoradiotherapy with docetaxel plus nedaplatin in comparison to cisplatin plus 5-fluorouracil for locally advanced esophageal carcinoma.Methods A total of 82 patients with locally advanced esophageal carcinoma confirmed by histopathological diagnosis were randomized into two groups： docetaxel plus nedaplatin（DN） group（n=41） and cisplatin plus 5-fluorouracil（PF） group（n=41）.The patients in the two groups received two cycles of inductive and concomitant chemotherapy with DN regimen or PF regimen,followed by concurrent conformal radiotherapy.The endpoints were the acute toxicity and short-term efficacy.Results Fewer patients in the DN group suffered from grade 3-4 nausea and vomiting than in the PF group（19.5% vs 46.3%,P =0.018）,whereas more grade 3-4 neutropenia occurred in the DN group than in the PF group（48.8% vs 26.8%,P =0.068） There was no significant difference in short-term efficacy between the two groups（P=0.737）.Conclusions DN regimen is effective and well-tolerated in patients with locally advanced esophageal carcinoma,and the short term response rate between DN regimen and PF regimen is similar.DN regimen shows a significant superiority in reducing nausea and vomiting.

关 键 词：食管癌 新辅助化疗 同期放化疗 多西他赛 奈达铂 

分 类 号：R735.1[医药卫生—肿瘤]