目的 观察多西紫杉醇加顺铂化疗(DC)同步放疗与顺铂加氟尿嘧啶(PF)化疗同步放疗中晚期食管癌的疗效和毒副反应.方法 将48例食管鳞癌患者随机分成多西紫杉醇加顺铂化疗同步放疗组(DC组)和顺铂加氟尿嘧啶化疗同步放疗组(PF组)各24例.DC组采用多西紫杉醇75mg/m2 iv d1,+顺铂25mg/m2 iv d1-3,28d为一周期,共4周期.PF组采用顺铂25 mg/m2 iv d1-3、氟尿嘧啶500 mg/m2,连用5d,28 d为1周期,共4周期.两组放疗方法相同,采用普通放疗总剂量60.Gy/30 f/6周.结果 两组近期疗效比较无统计学意义(Z=1.106,P=0.269).DC组和PF组的3年中位生存时间分别为26个月(95%CI:24.579～27.421)、23个月(95%CI:21.896～24.104),log ranktest差异无显著性(x2=3.4041,P=0.065).DC组与PF组的放射性食管炎比较有统计学意义(P＝0.049),而骨髓抑制、胃肠道反应方面比较无统计学意义.结论 多西紫杉醇加顺铂同步放化疗可用于治疗中晚期食管鳞癌且安全可靠.%Objective To compare the therapeutic effect and adverse effects of two regimens, namely cisplatin and docetaxel (DC) regimen and fluorouracil (PF) regimen, both with concurrent radiotherapy, in the treatment of advanced esophageal squamous cancer. Methods Forty-eight patients with esophageal squamous cancer were randomly assigned in DC regimen and PF regimen groups. All the patients received conventional radiotherapy at a total dose of 60 Gy (in 30 fractions) for 6 weeks, hi DC regimen group, the patients received intravenous infusion of docetaxel (75 mg/m2) for 1 h on day 1 and DDP (25 mg/m2 daily) on days 1-3, with every 28 days as one cycle. PF regimen consisted of cisplatin (25 mg/m2) on days 1-3 and continuous intravenous infusion of fluorouracil (500 mg/m2) for 5 days, with every 28 days as one cycle. All the patients were suggested to have no less than 2 cycles. Results The 3-year median survival time in DC regimen was slightly longer than that in PF regimen group (26 vs 23 months, X2= 3.4041, P=0.065). The same result was also found in the short-term effect and adverse reactions including myelosuppression and gastrointestinal reactions. Only the adverse reaction of radiotherapy-induced esophagitis showed a significant difference between the two groups (P=0.049). Conclusion DC regimen with synchronous radiotherapy is effective and safe for treating advanced esophageal squamous cancer.
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