胃食管连接部肿瘤化疗的现状  

Chemotherapy for Gastroesophageal Junction Tumors

作　　者：薛雾松[1] 门斯烨[1] 刘宝清[1] 余文[1] 张少辉[1] 刘会良[1] 杨成城[1] 吴伟[1] 

机构地区：[1]北京中医药大学东方医院普通外科,北京100078

出　　处：《医学综述》2015年第11期1983-1986,共4页Medical Recapitulate

摘　　要：氟嘧啶和铂制剂的联合应用是胃食管癌姑息化疗中的一种推荐方案。新的方案包括短期输注5-氟尿嘧啶(5-FU)的替代药物或口服5-FU的前体药物,使用奥沙利铂替代顺铂。虽然在目前临床用药中增加了表阿霉素,但还没有得到随机试验的支持。多西他赛、顺铂、5-FU方案与5-FU联合顺铂方案相比稍微改善了生存期,但却明显增加了不良反应。近期有试验发现,包含依立替康的方案并不优于5-FU联合顺铂或单纯输注5-FU。不过,5-FU联合依立替康方案不良反应轻微使该方案成为一线治疗的一种选择。除了在姑息治疗中的作用,围术期和术后化疗还可以提高约15%的生存率。术前放化疗也可以改善预后。A doublet of fluoropyrimidine and platinum compound remains a recommended palliative chemotherapy for esophagogastric cancers.Newer regimens involve the short-term infusion of substitution of 5-fluorouracil （5-FU） or oral 5-FU prodrugs and the replacement of cisplatin with oxaliplatin.Although the addition of epirubicin is part of routine practice,there are no randomized data to support a benefit.Docetaxel, cisplatin and 5-FU regimen has been shown to modestly improve survival compared with 5-FU and cisplatin alone but at the expense of significant additional toxicity .Irinotecan-containing regimens have also been eval-uated in a few trials but are not clearly superior to 5-FU and cisplatin or even infusional 5-FU alone.Never-theless, their favorable toxicity profile indicates that infusional 5-FU and irinotecan regimens also represent a first-line therapy option.In addition to its primary role in palliative therapy,there are also established peri-or postoperative chemotherapy strategies that increase survival rates by approximately 15% compared with sur-gery alone.Preoperative chemo-radiotherapy has also been shown to improve the outcomes.

关 键 词：胃食管癌 姑息治疗 化疗 

分 类 号：R453.9[医药卫生—治疗学]