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目的 观察大剂量顺铂 (DDP)、氟脲嘧啶 ( 5 Fu)和平阳霉素 (PYM )联合化疗方案治疗晚期食管癌的疗效和安全性。方法 对 5 3例不能手术切除和无根治性放疗指征的晚期食管鳞癌患者 ,采用 2组不同剂量的方案进行联合化疗。随机分为 2组 ,治疗组每周期顺铂 12 0mg/m2 、5 Fu 15 0 0mg/m2 和PYM 3 6mg/m2 ,对照组剂量分别是 60mg/m2 、10 5 0mg/m2 和 2 4mg/m2 。结果 治疗组有效率 (CR +PR ) 61.5 % ,高于对照组 ( 2 9.6% ) ,有显著性差异 (P <0 .0 5 )。全组病人均有不同程度的消化道反应、骨髓毒性及脱发 ,治疗组较对照组明显 ,主要为恶心、呕吐 ,但患者均能耐受。结论 适当强化DDP、5 Fu和PYM剂量将提高食管癌的疗效。
Objective To observe the efficacy and safety of high-dose cisplatin (DDP), fluorouracil (5 Fu) and bleomycin (PYM) combined with chemotherapy in the treatment of advanced esophageal cancer. Methods A total of 53 patients with advanced esophageal squamous cell carcinoma who could not be surgically removed and who did not have radical radiotherapy were treated with two different doses of combination chemotherapy. The patients in the treatment group were randomly divided into two groups: the treatment group received cisplatin 120 mg / m 2, 5 Fu 15 0 0 mg / m 2 and PYM 3 6 mg / m 2 cyclophosphamide in the treatment group and 60 mg / m 2, 105 mg / m 2 and 24 mg / m 2 . Results The effective rate of treatment group (CR + PR) was 61.5%, which was significantly higher than that of control group (9.6%) (P <0.05). All patients had different degrees of gastrointestinal reactions, bone marrow toxicity and hair loss, the treatment group was significantly more than the control group, mainly nausea and vomiting, but patients can tolerate. Conclusion Appropriate enhancement of DDP, 5 Fu and PYM doses will improve the efficacy of esophageal cancer.