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食管癌是我国最常见的恶性肿瘤之一,治疗采用手术、放疗、化疗综合治疗模式。食管癌化疗一直采用铂类药物为基础的联合方案。顺铂治疗食管癌疗效确切,用于新辅助化疗、辅助化疗,同期联合放疗和晚期病例的解救化疗。联合5-FU的化疗方案在在食管癌同期放化疗、解救化疗中是被认为是标准方案。与顺铂相比,卡铂的肾毒性、胃肠道反应、耳毒性均低于顺铂,治疗食管癌并未显示出更多的优势。奥沙利铂治疗食管腺癌显示出较好的有效率和中位生存期,较顺铂降低了肾毒性和胃肠道反应,但外周神经毒性发生率高。奈达铂治疗食管鳞癌疗效确切,总体治疗效果不劣于含顺铂的联合方案,临床用于晚期食管癌的解救化疗、同期联合放疗等,因具较严重的骨髓抑制,代替DDP用于食管鳞癌的一线治疗还需更加确凿的循证依据,对食管腺癌疗效尚不清楚。洛铂、5-FU及亚叶酸钙联合方案治疗晚期食管癌疗效和安全性较好,主要不良反应是可逆性骨髓抑制和胃肠道反应,值得进一步研究。
Esophageal cancer is one of the most common malignant tumors in our country. The treatment adopts the mode of operation, radiotherapy and chemotherapy. Chemotherapy for esophageal cancer has been using platinum-based drug-based regimens. Cisplatin treatment of esophageal cancer exact effect for neoadjuvant chemotherapy, adjuvant chemotherapy, concurrent radiotherapy and advanced cases of rescue chemotherapy. Chemotherapy regimen combined with 5-FU is considered as a standard protocol in concurrent chemoradiotherapy and rescue chemotherapy of esophageal cancer. Compared with cisplatin, carboplatin nephrotoxicity, gastrointestinal reactions, ototoxicity were lower than cisplatin, esophageal cancer treatment did not show any more advantages. Oxaliplatin treatment of esophageal adenocarcinoma showed good efficiency and median survival, compared with cisplatin reduced nephrotoxicity and gastrointestinal reactions, but the high incidence of peripheral neurotoxicity. Nedaplatin treatment of esophageal squamous cell carcinoma of the exact effect of the overall treatment is not inferior to the cisplatin-containing combination of clinical esophageal cancer for the rescue and treatment of chemotherapy, combined with radiotherapy over the same period, due to more severe bone marrow suppression, instead of DDP for The first-line treatment of esophageal squamous cell carcinoma needs a more conclusive evidence-based, efficacy of esophageal adenocarcinoma is not yet clear. The efficacy and safety of lobaplatin, 5-FU and leucovorin combination regimen in the treatment of advanced esophageal cancer are good. The main adverse reactions are reversible myelosuppression and gastrointestinal reactions, which deserve further study.