摘要:
Objective To observe the effect of high-dose leucovorin(LV)plus 5-fluorouracil(5-Fu)for 48hours infusion in combination with cisplatin(DDP)in treatment of advanced esophageal cancer.Methods Pathological diagnosis of esophageal cancer 60 cases were randomly divided into treatment group of 30 patients,using DDP 25mg/m2 intravenous infusion 30 minutes,d1~3,LV 200mg/m2 intravenous infusion 2 hours,5-Fu 0.5 intravenous injection 10 minutes,and 5-Fu 2.5/m2,continuous infusion with the infusion pump for 48 hours every 21 days,2 cycles of assessment of efficacy.Control group of 30 patients,using DDP 25mg/m2 intravenous infusion 30 minutes,d1~3,LV 60mg/m2 intravenously two hours,d1~5,5-Fu 500mg/m2 intravenously 8 hours every 21 days,2 cycles of assessment of efficacy.Results Short-term effect,treatment group,complete remission(CR)1 patient and partial remission(PR)15 cases,stable(SD)9 cases,progress(PD)5 cases,the total effective rate of CR + PR53.3%(16/30).Control group,PR 11 patients,SD 11 cases,PD 8 cases,no cases of PR,the total effective rate 36.7 %(11/30).Nausea,vomiting,oral mucositis,bone marrow suppression,diarrhea and hair loss were the main adverse reactions.Two groups are able to withstand,without any Ⅳ toxicities,myelosuppression was significant in control group than the treatment group.Conclusion High-dose LV + 5-Fu 48 hours infusion combined platinum-term efficacy in treatment of advanced esophageal cancer compared with conventional DF program is good,less adverse reactions,should further expand the study.%目的 观察大剂量醛氢叶酸(Leucovorin,LV)加氟尿嘧啶(5-Fluorouracil,5-Fu)持续48 h滴注联合顺铂(Cisplantin,DDP)治疗晚期食管癌与传统DF方案疗效及其不良反应的差别.方法 病理确诊的食管癌60例,随机分成治疗组30例,采用DDP 25 mg/m2静脉滴注30 min,第1~3天;LV 200 mg/m2静脉滴注2h,5-Fu 0.5静脉注射10 min,然后5-Fu 2.5/m2,用输液泵连续输注48 h,每21天重复,2个周期以上评定疗效.对照组30例,采用DDP 25mg/m2静脉滴注30 min,第1~3天;LV 60 mg/m2静脉滴注2h,第1~5天,5-Fu 500 mg/m2静脉滴注8h,每21天重复,2个周期以上评定疗效.结果 近期疗效,治疗组,完全缓解(CR)1例,部分缓解(PR)15例,稳定(SD)9例,进展(PD)5例,总有效率CR+ PR53.3%(16/30).对照组,PR 11例,SD 11例,PD 8例,无PR病例,总有效率36.7%(11/30).恶心、呕吐、口腔粘膜炎、骨髓抑制、腹泻及脱发为主要不良反应.两组均能耐受,未发生Ⅳ度毒性,骨髓抑制对照组比治疗组明显.结论 大剂量LV+ 5-Fu 48 h滴注联合铂治疗晚期食管癌近期疗效较传统DF方案好,不良反应较小,值得进一步扩大研究.