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目的观察小剂量甲地孕酮联合TP方案(紫杉醇+顺铂)治疗晚期食管癌的效果。方法晚期食管癌患者40例,随机分为治疗组21例和对照组19例,对照组给予TP方案(紫杉醇+顺铂)化疗,21d为1个周期;治疗组化疗药物用法、用量同对照组,并于每周期化疗前给予甲地孕酮160mg/次,1次/d,口服,连用7d。化疗2个周期后评价2组疗效,比较2组化疗前、后体质量、KPS评分、血浆白蛋白及血红蛋白水平变化,记录不良反应发生情况。结果化疗2个周期后,治疗组总有效率(38.1%)与对照组(26.3%)比较差异无统计学意义(P>0.05);治疗组化疗2个周期后体质量、KPS评分、血浆白蛋白及血红蛋白水平((68.0±9.5)kg、85.0±8.5、(49.0±5.0)g/L、(130.0±11.5)g/L)高于治疗前((66.0±9.0)kg、80.0±8.0、(45.0±6.1)g/L、(120.0±10.5)g/L)(P<0.05),且高于对照组化疗后((64.0±7.8)kg、79.0±7.4、(45.0±6.7)g/L、(120.4±9.3)g/L)(P<0.05),对照组化疗前、后各指标比较差异无统计学意义(P>0.05);2组腹泻、恶心呕吐、白细胞下降、血小板下降发生率比较差异无统计学意义(P>0.05)。结论小剂量甲地孕酮联合TP方案化疗可改善晚期食管癌患者的生活质量。
Objective To observe the effect of low dose megestrol combined with TP regimen (paclitaxel + cisplatin) in the treatment of advanced esophageal cancer. Methods Forty patients with advanced esophageal cancer were randomly divided into treatment group (n = 21) and control group (n = 19). The control group received TP regimen (paclitaxel plus cisplatin) chemotherapy for 21 days. The chemotherapy group used the same dosage as the control group , And given megesterone 160mg / time, once a day, orally and once every 7 days before each cycle of chemotherapy. After 2 cycles of chemotherapy, the two groups were evaluated. The changes of body mass, KPS, plasma albumin and hemoglobin before and after chemotherapy were compared between the two groups, and the incidence of adverse reactions was recorded. Results After 2 cycles of chemotherapy, the total effective rate (38.1%) in the treatment group was not significantly different from that in the control group (26.3%) (P> 0.05). The body mass, KPS score, (68.0 ± 9.5) kg, 85.0 ± 8.5, (49.0 ± 5.0) g / L and (130.0 ± 11.5) g / L were significantly higher than those before treatment (66.0 ± 9.0) kg and 80.0 ± 8.0 (45.0 ± 6.1) g / L and (120.0 ± 10.5) g / L, respectively, which were significantly higher than those in the control group (64.0 ± 7.8g, 79.0 ± 7.4, 45.0 ± 6.7g / L, (120.4 ± 9.3) g / L, P <0.05). There was no significant difference between the two groups before and after chemotherapy (P> 0.05). Diarrhea, nausea and vomiting, leukopenia and thrombocytopenia The difference was not statistically significant (P> 0.05). Conclusion Low dose of megestrol combined with TP regimen can improve the quality of life of patients with advanced esophageal cancer.