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目的观察紫杉醇联合氟尿嘧啶、顺铂与奈达铂联合亚叶酸钙、氟尿嘧啶治疗晚期食管癌的临床疗效及毒副反应。方法 52例晚期食管癌患者随机以紫杉醇联合氟尿嘧啶、顺铂的方案或亚叶酸钙、奈达铂联合亚叶酸钙、氟尿嘧啶的方案化疗,均化疗2个周期以上,每个周期28d。结果紫杉醇联合氟尿嘧啶、顺铂方案(紫杉醇组)的有效率(CR+PR)为50.0%,毒副反应有胃肠道反应、神经毒性、关节肌肉疼痛及血液学毒性,Ⅲ～Ⅳ级胃肠道反应占12.5%,Ⅲ～Ⅳ级血液学毒性占41.7%。奈达铂联合亚叶酸钙、氟尿嘧啶方案(奈达铂组)的有效率(CR+PR)为46.4%,主要有血液学毒性,胃肠道反应,Ⅲ～Ⅳ级胃肠道反应为7.1%,Ⅲ～Ⅳ级血液学毒性为25.0%。结论紫杉醇联合氟尿嘧啶、顺铂治疗晚期食管癌与奈达铂联合亚叶酸钙、氟尿嘧啶治疗晚期食管癌相比,副反应均可耐受,疗效相当。奈达铂联合亚叶酸钙、氟尿嘧啶的副反应相对较少。
Objective To observe the clinical efficacy and side effects of paclitaxel plus fluorouracil, cisplatin and nedaplatin in combination with leucovorin and fluorouracil in the treatment of advanced esophageal cancer. Methods A total of 52 patients with advanced esophageal cancer were treated with paclitaxel plus fluorouracil and cisplatin or leucovorin, nedaplatin combined with leucovorin and fluorouracil for more than 2 cycles, each with 28 days. Results The effective rate (CR + PR) of paclitaxel plus fluorouracil and cisplatin (paclitaxel group) was 50.0%. The toxic and side effects were gastrointestinal reactions, neurotoxicity, joint and muscle pain and hematological toxicity. The grade Ⅲ ~ Ⅳ gastrointestinal Road reactions accounted for 12.5%, Ⅲ ~ Ⅳ hematological toxicity accounted for 41.7%. The effective rate (CR + PR) of nedaplatin plus leucovorin and fluorouracil regimen (nedaplatin group) was 46.4%, mainly including hematological toxicity, gastrointestinal reaction, gastrointestinal reaction of grade Ⅲ ~ Ⅳ was 7.1% , Grade Ⅲ ~ Ⅳ hematological toxicity was 25.0%. Conclusions Paclitaxel plus fluorouracil and cisplatin in the treatment of advanced esophageal cancer and nedaplatin in combination with leucovorin and fluorouracil in the treatment of advanced esophageal cancer, the side effects can be tolerated, with comparable efficacy. Nedaplatin combined with leucovorin, fluorouracil side effects are relatively small.