伊立替康联合顺铂治疗晚期食管癌临床的研究.doc

伊立替康联合顺铂治疗晚期食管癌临床的研究 　　【摘要】 目的 评价伊立替康联合顺铂方案(IP)和顺铂联合氟尿嘧啶(DF)方案治疗晚期食管癌的疗效及毒副反应。方法 95例确诊晚期食管癌患者,随机分为两组, PF方案组48例,IP方案组47例。每21 d为一周期,每二周期评价疗效。结果 95例均可评价疗效,IP方案组总有效率55.3%,PF方案组总有效率41.7%,两组近期疗效比较,差异无统计学意义。IP方案组中位疾病进展时间(TTP)5.7个月,中位生存期11.2个月;PF组中位疾病进展时间(TTP)4.3个月,中位生存期9.1个月。IP方案组一年生存率46.8%,亦明显高于PF方案组37.5%。主要的毒副作用为恶心呕吐、骨髓抑制、腹泻等, 腹泻发生率二组之间比较差异具有统计学意义(P0. 05) ;其余二组之间比较差异均无统计学意义。两组病例均无化疗相关性死亡。结论 IP方案疗效要优于PF方案,毒副反应临床上可以接受,不失为晚期食管癌患者的一种选择。 　　【关键词】 伊立替康; 晚期食管癌; 联合化疗 　　 　　Clinical study of irinotecan in combinationwith cisplatin in treatmeant of advanced esophageal cancer 　　 　　ZHANG Cheng-hui,LI Ming,ZHANG Jing-wei,et al. 　　Department Of Oncology,Nan Yang Central Hospital,He Nan 473000,P.R.China 　　 　　【Abstract】 Objective To evaluate the efficacy and adverse events of irinotecan(CPT-11)combined with cisplatin(DDP)in the treatment of patients with advanced esophageal cancer. Methods A total of 95 cases with advanced esophageal entered this trial. The patients were randomly divided into trial group and control group, and 47 cases received chemotherapy of IP regimen ;48 cases received chemotherapy of PF regimen. Each patient received at least 2 cycles of chemotherapy.Results The efficacy and adverse events were evaluated in all patients. The overall response rate was 55.3% in the IP group and 41.7%in the PF group, the difference between the two groups did not reach statistical significance (P0. 05) . The median time to progression(MTTP)was 5.7 months in the IP group and 4.3 months in the PF group.The median survival time(MST)was 11.2 months in the IP group and 9.1 months in the PF group. The main adverse events included myelosuppression,nausea,vomiting and diarrhea. Alone diarrhea with statistically significant difference detected(P0. 05).Conclusion For advanced esophageal cancerpatients,IP treatment achieves better therapeutic effects than DF treatment. It is toxicity is tolerable, It is valuable for clinical practicing. 　　【Key words】 Irinotecan; Advanced esophageal cance