紫杉醇联合顺铂与5-Fu联合顺铂同步放疗治疗食管癌的疗效对比  

Radiotherapy concurrent with paclitaxel plus cisplatin vs 5-fluorouracil plus cisplatin for esophageal cancer

作　　者：王娟[1] 余跃[2] 詹必红[1] 葛宁[1] 周庆[1] 

机构地区：[1]安徽省肿瘤医院(安徽省立医院西区)放疗科,安徽省合肥市230022 [2]山东大学医学院安徽省医学研究生培养基地 安徽省立医院消化内科,安徽省合肥市230001

出　　处：《世界华人消化杂志》2015年第24期3904-3908,共5页World Chinese Journal of Digestology

摘　　要：目的:分析比较紫杉醇联合顺铂与顺铂联合5-氟尿嘧啶(5-fluorouracil,5-Fu)同步放疗治疗食管癌的临床疗效以及不良反应.方法:收治病理确诊的食管癌患者53例随机分为两组进行同步放化疗:紫杉醇(125 m g/m2,d1)联合顺铂(20 mg/m2,d1-3)同步放疗组(TP组,25例);5-Fu(500 mg/m2d1-5)联合顺铂(20 m g/m2,d1-4)同步放疗组(D F组,28例).两组方案28 d为1周期,放疗第4周时重复第2个疗程.放射治疗剂量为56-60 Gy,2 Gy/次,5次/wk.随访时间为1年并比较两组局部控制率、生存率以及不良反应.结果:T P组及D F组局部控制率分别为85.00%和89.29%;1年生存率分别为76.00%和85.71%(P>0.05).不良反应提示T P组(3 2.0 0%)放疗性食管炎发生率低于D F组(53.57%)(P>0.05);但TP组(60.00%)粒细胞减少发生率高于DF组(42.86%)(P<0.05).结论:TP组与DF组两种方案治疗食管癌近期疗效相仿,TP组放射性食管炎发生率较低同步放疗耐受性较佳,TP方案可以作为DF方案的替代方案治疗,但TP方案药物剂量应用仍需进一步优化.AIM：To compare the efficacy and side effects of paclitaxel plus cisplatin vs cisplatin plus5-fluorouracil（5-Fu）,in combination with concurrent radiation in patients with esophageal cancer.METHODS：Fifty-three patients who were pathologically diagnosed with esophageal cancer were randomly into two groups.One group of patients were treated with paclitaxel（125 mg/ m^2,d1） combined with cisplatin（20mg/ m^2,d1-3）,and the other group of patients received 5-Fu（500 mg/ m^2,d1-5） combined with cisplatin（20 mg/ m^2,d1-4）.Patients in both groups received a concurrent radiotherapy,2Gy/ d,5 times/ wk,at a total dose of 56-60 Gy.All the patients were followed for one year,and the local control rate,survival rate,and other clinical and laboratory data were compared between the two groups.RESULTS：The local control rates and oneyear survival rates between the two groups were 85.00%vs 89.29%and 76.00%vs85.71%respectively,which demonstrated no statistically difference.The overall rate of adverse reactions was significantly lower in patients administered with the apaclitaxelcisplatin regimen than in those treated with cisplatin plus 5-Fu（32.00%vs 53.60%,P〉 0.05）,while the incidence of neutropenia was more frequent in patients who received the apaclitaxel-cisplatin regimen（60.00%vs42.86%,P〈 0.05）.CONCLUSION：Both paclitaxel-cisplatin and cisplatin-5-Fu regimens,in combination with concurrent radiotherapy,are effective in the treatment of esophageal cancer.Patients receiving paclitaxel-cisplatin regimen are relatively apt to neutropenia,which needs more attention.

关 键 词：食管癌 放射疗法 药物疗法 紫杉醇 

分 类 号：R735.1[医药卫生—肿瘤]