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目的对比FOLFOX4方案和OLF方案一线治疗晚期食管癌的疗效和不良反应。方法将92例患者分为FOLFOX4组和OLF组各46例,FOLFOX4组应用L-OHP 85mg/m2静脉滴注,第1d;CF 200mg/m2静脉滴注,第1、2d;5-FU 400mg/m2静脉推,第1、2天,5-FU 600 mg/m2持续静脉注射22h第1、2天,14天为一周期。OLF组应用L-OHP 130mg/m2静脉滴注第1d;CF 200 mg/m2静脉滴注,第1～5d,5-FU 500mg/m2静脉滴注,第1～5d,21d为1周期。结果 FOLFOX4组和OLF组的客观缓解率分别为52.2%和47.8%(P>0.05);中位疾病进展时间为6.3个月和5.5个月(P>0.05);1年生存率分别为45.5%和43.1%(P>0.05)。骨髓抑制发生率分别为69.5%和68.4%(P>0.05),恶心呕吐发生率分别为49.6%和76.5%(P<0.05),外周神经毒性发生率分别为57.3%和37.5%(P<0.05)。结论 FOLFOX4方案和OLF方案一线治疗晚期食管癌疗效相近,前者消化道毒性较轻,外周神经毒性较重。
Objective To compare the efficacy and side effects of first-line treatment of advanced esophageal cancer with FOLFOX4 regimen and OLF regimen. Methods Forty-two patients were divided into FOLFOX4 group and OLF group, 46 cases in each group. FOLFOX4 group was treated with L-OHP 85mg / m2 intravenously on the 1st day, CF 200mg / m2 intravenously on the 1st and 2nd day, m2 intravenous push, 1,2 days, 5-FU 600 mg / m2 continuous intravenous injection of 22h 1,2 days, 14 days for a cycle. In the OLF group, intravenous infusion of L-OHP 130mg / m2 for 1 day, CF 200 mg / m2 for intravenous infusion 1 to 5 days, and 5-FU 500mg / m2 for intravenous infusion 1 to 5 days and 21 days for 1 cycle. Results The objective response rates of FOLFOX4 group and OLF group were 52.2% and 47.8% respectively (P> 0.05). The median progression time was 6.3 months and 5.5 months (P> 0.05). The 1-year survival rates were 45.5% And 43.1% (P> 0.05). The incidence of myelosuppression was 69.5% and 68.4% respectively (P> 0.05). The incidence of nausea and vomiting was 49.6% and 76.5% respectively (P <0.05), and the incidence of peripheral neurotoxicity was 57.3% and 37.5% ). Conclusion FOLFOX4 regimen and OLF regimen are similar in the treatment of advanced esophageal cancer. The former has less gastrointestinal toxicity and more peripheral neurotoxicity.