紫杉醇或5-氟尿嘧啶联合顺铂同步放疗方案治疗老年中晚期食管癌患者的临床效果及安全性  

Clinical efficacy and safety of cisplatin combined with paclitaxel or 5-fluorouracil and concurrent radiotherapy for elderly patients with advanced esophageal cancer

作　　者：渠红[1] 刘敏[1] 谢枫[1] QU Hong;LIU Min;XIE Feng(Department of Oncology,Hospital of Xinjiang Production and Construction Corps,Urumqi 830002,China)

机构地区：[1]新疆生产建设兵团医院肿瘤科,乌鲁木齐830002

出　　处：《中华老年多器官疾病杂志》2021年第6期439-443,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的比较紫杉醇或5-氟尿嘧啶联合顺铂同步放疗方案治疗老年中晚期食管癌患者的效果及安全性。方法选择2016年5月至2018年6月在新疆生产建设兵团医院进行治疗的102例老年中晚期食管癌患者为研究对象,将患者随机分为紫杉醇组(n=52)和5-氟尿嘧啶组(n=50)。比较2组患者的治疗效果、2年生存率、胃肠道副反应、肝肾功能损伤及骨髓抑制情况。采用SPSS 25.0统计软件进行数据分析。分类资料采用χ^(2)检验和Fisher精确检验,临床疗效及安全性评价采用Kaplan-Meier分析和Log-rank检验。结果紫杉醇组和5-氟尿嘧啶组治疗有效率分别为65.38%(34/52)和62.00%(31/50),差异无统计学意义(P>0.05);控制率分别为94.23%(49/52)和70.00%(35/50),差异有统计学意义(P=0.032);2年生存率差异无统计学意义(P>0.05)。紫杉醇组患者恶心呕吐和骨髓抑制的发生率分别为40.38%(21/52)和67.31%(35/52),与5-氟尿嘧啶组的74.00%(37/50)和28.00%(14/50)比较,差异均有统计学意义(P<0.05);肝、肾功能损伤的发生率差异无统计学意义(P>0.05)。结论紫杉醇联合顺铂同步放疗方案治疗老年中晚期食管癌患者的疗效与5-氟尿嘧啶联用顺铂同步放疗相近,且不易引起胃肠道不良反应和骨髓抑制。Objective To compare the efficacy and safety of cisplatin combined with paclitaxel or 5-fluorouracil and concurrent radiotherapy for elderly patients with advanced esophageal cancer.Methods A total of 102 elderly patients with advanced esophageal cancer who were treated in our hospital from May 2016 to June 2018 were recruited as the research objects,and then randomly divided into paclitaxel group(n=52)and 5-fluorouracil group(n=50).The therapeutic efficiency,2-year survival rate,gastrointestinal side effects,kidney and hepatic impairment and bone marrow suppression were compared and analyzed between the two groups.SPSS statistics 25.0 was used to perform the statistical analysis.Chi-square test and Fisher exact test were employed for data analyses,and Kaplan-Meier analysis and Log-rank test were adopted to evaluate clinical efficacy and safety of the regimens.Results The efficiency rate was 65.38%(34/52)and 62.00%(31/50)respectively in the paclitaxel group and 5-fluorouracil group(P>0.05).But the control rate was 94.23%(49/52)and 70.00%(35/50)respectively,with statistically difference between the two groups(P=0.032).There was no significant difference in 2-year survival rate(P>0.05).The incidences of nausea and vomiting,and bone marrow suppression were 40.38%(21/52)and 67.31%(35/52)respectively in the paclitaxel group,and 74.00%(37/50)and 28.00%(14/50)in the 5-fluorouracil group(P<0.05).The incidences of kidney and hepatic impairment did not differ between two groups.Conclusion The regimen of paclitaxel combined with cisplatin and concurrent radiotherapy shows a similar therapeutic efficacy as the regimen with 5-fluorouracil+cisplatin+concurrent radiotherapy for the elderly patients with advanced esophageal cancer,and causes less adverse reactions in gastrointestinal tract and less bone marrow suppression in the patients.

关 键 词：老年人 食管癌 中晚期 紫杉醇 5-氟尿嘧啶 顺铂 同步放化疗 

分 类 号：R735.1[医药卫生—肿瘤]