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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21d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(P<0.05);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。
Objective To evaluate the efficacy and toxicity of irinotecan combined with cisplatin (IP) and cisplatin combined with fluorouracil (DF) regimen in the treatment of advanced esophageal cancer. Methods Ninety-five patients with advanced esophageal cancer were randomly divided into two groups: 48 in PF group and 47 in IP group. Every 21d for a cycle, evaluation of the efficacy of every two cycles. Results All of the 95 cases were evaluated. The total effective rate was 55.3% in the IP group and 41.7% in the PF group. There was no significant difference in the short-term curative effect between the two groups. The median duration of disease progression (TTP) was 5.7 months in the IP regimen and the median survival was 11.2 months. The median time to progression (TTP) in the PF group was 4.3 months, with a median survival of 9.1 months. The one-year survival rate was 46.8% in IP group and 37.5% in PF group. The main side effects were nausea and vomiting, myelosuppression, diarrhea and so on. The incidence of diarrhea was statistically significant between the two groups (P <0.05). There was no significant difference between the other two groups. There was no chemotherapy-related death in both groups. Conclusion The efficacy of IP regimen is better than that of PF regimen. Toxic and side effects can be accepted clinically, which is an option for advanced esophageal cancer patients.