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目的 :探讨顺铂为主的新辅助化疗对中晚期食管癌预后的影响。 方法 :对 35例拟行手术的中晚期食管癌患者实施术前联合化疗 ,化疗方案 :顺铂 (DDP) 4 0mg/m2 、5 氟尿嘧啶 (5 FU ) 6 0 0mg/m2 、丝裂霉素 (MMC) 4mg/m2 、长春新碱 (VCR) 1mg/次 ,于第 1、8、15、2 1天静脉点滴化疗药物 ,顺铂用药前水化。化疗后第 14～ 2 1天手术。 结果 :完全缓解 (CR) 2例 ,部分缓解 (PR) 18例 ,近期有效率 6 4 .5 %。骨髓抑制 1级 12例 (31.5 % ) ,2级 8例(2 2 .9% ) ,3级 3例 (8.6 % ) ,抑制率 6 5 .7%。本组病人中位生存期 2 5个月 ,1年生存期 75 % ,3年生存期 4 4 %。 结论 :顺铂为主的新辅助化疗对于食管鳞癌近期疗效肯定 ,局部未控仍然是联合治疗后患者死亡的主要原因 ,因此不能轻视外科技术细节对肿瘤局部病灶切净的影响。
Objective: To investigate the effect of cisplatin-based neoadjuvant chemotherapy on the prognosis of advanced esophageal cancer. Methods: Thirty-five patients with advanced esophageal cancer undergoing surgery underwent preoperative chemotherapy. The chemotherapy regimens were 40 mg / m2 for cisplatin (DDP) and 600 mg / m2 for 5-fluorouracil (5 FU) MMC) 4mg / m2, vincristine (VCR) 1mg / time, on the 1st, the first, the first 15,15,21 intravenous chemotherapy drugs, cisplatin hydration before treatment. After chemotherapy 14 to 21 days surgery. Results: Complete remission (CR) in 2 cases, partial remission (PR) in 18 cases, the recent efficiency of 64.5%. Myelosuppression was grade 1 in 12 cases (31.5%), grade 2 in 8 cases (22.9%), grade 3 in 3 cases (8.6%) and inhibition rate was 6.57%. The median survival time of patients in this group 25 months, 75% of 1-year survival, 4-year survival of 4 4%. CONCLUSIONS: Cisplatin-based neoadjuvant chemotherapy has a positive curative effect on esophageal squamous cell carcinoma in the near future. It is still the main cause of death after esophageal squamous cell carcinoma. Therefore, the influence of surgical technique on the tumor necrosis can not be ignored.