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目的 探讨羟基喜树碱为主的联合化疗方案治疗中晚期肺癌、食管癌和消化道肿瘤的临床疗效和毒副反应。方法 小细胞肺癌应用HEP方案 :HCPT 8mg m2 静脉滴注 ,DDP 15mg m2 静脉滴注 ,VP 16 70mg m2 静脉滴注 ,连用 5d。非肺小细胞癌应用HAP :HCPT、DDP同前 ,ADM THP 2 0mg m2 静脉推注 ,1、2d(或 6、7d)。食管癌应用HLFP方案 :HCPT、DDP同前 ,LV 10 0mg ,5 Fu 5 0 0mg m2 静脉滴注 ,连用 5d。消化道癌应用HMLF方案 :HCPT、LV、5 Fu同前 ,MTX 6 0mg m2 静脉推注 1d。以上方案每 4周重复为 1周期 ,2周期为 1疗程。结果 近期疗效 :180例中 ,CR者 14例 (7.8% ) ,PR者 87例 (48..3% ) ,SD者 6 6例 (36 .7% ) ,有效率 (CR +PR) 5 6 .1% ,化疗受益率 (CR +PR +SD) 93 .9%。其中 ,初治 12 6例 ,CR11例 ,PR 6 4例 ,有效率 5 9.5 % ;复治 5 4例 ,CR 3例 ,PR 2 3例 ,有效率 48.1%。小细胞肺癌局限期 14例 ,CR 5例 ,PR 7例 ,有效率 85 .7% ;广泛期 9例 ,CR 1例 ,PR 5例 ,有效率 6 6 .7%。非小细胞肺癌 79例 ,CR4例 ,PR 39例 ,有效率 5 4.4%。食管癌 2 9例 ,CR 2例 ,PR 12例 ,有效率 48.3 %。消化道癌 49例 ,CR 1例 ,PR 2 4例 ,有效率 5 1%。毒副反应主要为骨髓抑制、消化道反应如恶心、呕吐、腹泻 ,症状轻微都能耐
Objective To investigate the clinical efficacy and toxicity of hydroxycamptothecine-based combination chemotherapy in the treatment of advanced lung cancer, esophageal cancer and gastrointestinal cancer. Methods HEP with small cell lung cancer: HCPT 8mg m2 intravenous drip, DDP 15mg m2 intravenous drip, VP 16 70mg m2 intravenous drip for 5 days. Non-small cell lung cancer with HAP: HCPT, DDP with the former, ADM THP 2 0mg m2 intravenous injection, 1,2d (or 6, 7d). Application of HLFP program for esophageal cancer: HCPT, DDP with the former, LV 10 0mg, 5 Fu 500 mg m2 intravenous infusion for 5 days. The HMLF protocol was used for gastrointestinal cancer: HCPT, LV, 5 Fu with the former, and MTX 60 mg m2 for 1 d. The above protocol is repeated every 4 weeks for 1 cycle, 2 cycles for 1 course of treatment. Results Short-term results: Of the 180 patients, 14 were CR (7.8%), 87 were PR (48..3%), and 6 were SD (36.7%). The effective rate (CR + PR) 5 6 .1%, chemotherapy benefit rate (CR +PR +SD) 93.9%. Among them, the initial treatment of 126 cases, CR11 cases, PR 64 cases, efficiency of 9.55%; retreatment of 54 cases, CR3 cases, PR23 cases, an effective rate of 48.1%. There were 14 cases of small cell lung cancer with limited period, 5 cases of CR, 7 cases of PR, and an effective rate of 85.7%. There were 9 cases of extensive stage, 1 case of CR, 5 cases of PR, and an effective rate of 66.7%. There were 79 cases of non-small cell lung cancer, 4 cases of CR, and 39 cases of PR. The effective rate was 5 4.4%. There were 29 cases of esophageal cancer, 2 cases of CR, 12 cases of PR, and an effective rate of 48.3%. There were 49 cases of gastrointestinal cancer, 1 case of CR, 4 cases of PR, and an effective rate of 51%. The toxic side effects are mainly myelosuppression, gastrointestinal reactions such as nausea, vomiting, diarrhea, mild symptoms can be tolerated