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目的:观察沙利度胺(TLD)联合紫杉醇(PTX)与奈达铂(NDP)方案治疗晚期食管鳞癌的疗效及沙利度胺对血清VEGF变化的影响。方法:60例晚期食管鳞癌患者随机分为联合用药组(TLD+PTX+NDP)30例和化疗组(PTX+NDP)30例,观察两组之间不同的临床疗效、毒副反应和患者血清中VEGF浓度与疗效的相关性。结果:联合用药组有效率56.7%,化疗组有效率43.3%,两组比较差异无统计学意义,P=0.302;联合用药组化疗2个周期后血清VEGF浓度较化疗前显著降低(P=0.000),而化疗组差异无统计学意义,P=0.410。联合组恶心呕吐毒副反应较化疗组(P=0.035)发生率小,但头晕(P=0.001)和便秘(P=0.001)发生率高。结论:沙利度胺可降低晚期食管鳞癌血清VEGF浓度,并且降低化疗导致的严重消化道不良反应的发生率。
Objective: To observe the curative effect of thalidomide combined with paclitaxel (PTX) and NDP on advanced esophageal squamous cell carcinoma and the effect of thalidomide on serum VEGF. Methods: Sixty patients with advanced esophageal squamous cell carcinoma (ESCC) were randomly divided into 30 patients in combination group (TLD + PTX + NDP group) and 30 patients in chemotherapy group (PTX + NDP group). The clinical efficacy, side effects, Serum VEGF concentration and efficacy of the correlation. Results: The effective rate was 56.7% in the combination group and 43.3% in the chemotherapy group, there was no significant difference between the two groups (P = 0.302). The serum VEGF concentration in the combination group was significantly lower than that before chemotherapy (P = 0.000 ), While there was no significant difference in chemotherapy group (P = 0.410). The incidence of nausea and vomiting in the combination group was lower than that in the chemotherapy group (P = 0.035), but the incidence of dizziness (P = 0.001) and constipation (P = 0.001) was high. Conclusion: Thalidomide can reduce the serum VEGF concentration in advanced esophageal squamous cell carcinoma and reduce the incidence of serious gastrointestinal adverse reactions caused by chemotherapy.