改良DCF方案与PF方案治疗晚期食管癌的临床疗效分析  

Clinical observation of modified DCF regimen versus PF regimen as treatment for advanced esophageal cancer

作　　者：侯娟[1] 吴志伟[1] 蔡俊[1] 陈青[1] 马德[1] 

机构地区：[1]江苏省靖江市人民医院肿瘤科,214500

出　　处：《齐齐哈尔医学院学报》2017年第20期2421-2423,共3页Journal of Qiqihar Medical University

摘　　要：目的分析改良DCF方案与PF方案治疗晚期食管癌的疗效和安全性。方法收集本院2012年1月至2015年4月收治的52例晚期食管癌患者为研究对象,根据化疗方案分为改良DCF组和PF组各26例。改良DCF方案:国产TXT 35~40 mg/m^2静滴,第1、15天;DDP 20 mg/m^2静滴,第2~3、16~17天;5-Fu 800 mg/m^248 h持续泵入,第2、16天。4周为1周期,至少化疗2个周期。PF方案:静脉滴注DDP 25 mg/m^2,第1~3天;持续静脉滴注5-Fu 500 mg/m^2,第1~5天;3周为1周期,至少化疗2个周期。比较两组的有效率(RR)、疾病控制率(DCR)和无进展生存期(PFS)。结果改良DCF组患者完成2~6个周期治疗,中位周期数3.2个周期,ORR为61.5%,显著高于PF组患者ORR为38.5%,差异有统计学意义(P<0.05);改良DCF组患者DCR为92.3%,高于PF组患者DCR为80.8%,差异无统计学意义(P>0.05)。随访3~16个月,改良DCF组患者中位PFS为8.5个月,PF组中位PFS为4.4个月,用Kaplan-Meier方法绘制疾病无进展生存率曲线,经Long-rank检验,两组中位PFS差异有统计学意义(P<0.5)。两组患者不良反应以骨髓抑制和胃肠道反应为主,差异无统计学意义(P>0.05),两组患者均未观察到严重肝肾损害,且未有化疗相关死亡事件发生。结论与传统PF方案相比,改良DCF方案一线治疗晚期食管癌的缓解率更佳,不良反应相似,可以作为常规治疗方案应用于临床。Objective To evaluate the efficacy and toxicity of modified DCF regimen compared with PF regimen as treatment for patients with advanced esophageal cancer. Methods 52 patients with advanced esophageal cancer were enrolled in this study from January 2012 to April 2015.26 patients received modified DCF regimen（ docetaxel 35 ~ 40 mg/m^2 iv,d1,15; cisplatin 20 mg/m^2 iv,d2 ~ 3,16 ~ 17; fluorouracil 800 mg/m^2 CIV48 h,d2,16; 28 days was a cycle） and 26 patients received PF regimen（ cisplatin 25 mg/m^2 iv,d1 ~ 3;fluorouracil 500 mg/m^2 civ d1 ~ 5; 21 days was a cycle）. The efficacy was evaluated every 2 cycles. The RR and DCR were analyzed between the two groups. Results Efficacy could be evaluated in all patients. Patients in modified DCF group achieved CR in 1 case,PR in 15 cases,SD in 8 cases and PD in 2 cases with RR of 61.5%and DCR of 92.3%. Patients in PF 4 group achieved CR in 1 case,PR in 9 cases,SD in 11 cases and PD in 5 cases with RR of 38.5% and DCR of 80.8%. The differences of RR between the two groups had significance（ P〈0.05）. The median PFS of m DCFgroup was 8. 5 months,and the PF group was 4. 4 months. Meanwhile,the differences of DCR had no differences（ P〈0. 05）. The main toxicities were myelosuppression and digestive tract reaction,and the incidence of the two groups had no differences（ P〈0. 05）. Conclusions Compared to the PF group,the modified DCF group can improve the RR rate of advanced esophageal cancer markedly with similar toxicity,can be used as a routine treatment scheme in clinical practice.

关 键 词：食管肿瘤 改良DCF方案 PF方案 

分 类 号：R739.63[医药卫生—肿瘤]