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目的:评价5-氟尿嘧啶(5-FU)按时辰低剂量节律式持续输注(CIV)治疗中晚期食管癌的近期疗效及耐受性。方法:将食管癌患者分为CIV治疗组(实验组)和常规化疗组(对照组)。实验组34例:顺铂(DDP)10mg,d1～d5,d8～d12;5-FU375mg,CIV,22∶00～10∶00,d1～d14,或联合紫杉醇90mg,d1,d8。对照组36例:DDP每周期总量100～120mg,分4～5d;醛氢叶酸100mg,d1～d5(5-FU前);5-FU750mg,CIV,d1～d5;紫杉醇用法同实验组。每21d为1个周期,两个周期后评价疗效及耐受性。结果:可评价患者70例,总有效率(CR+PR)为44.3%(31/70)。实验组化疗复治有效率为48.0%(12/25),高于对照组的13.3%(2/15),χ2=5.98,P<0.05。实验组KPS评分增加率为52.9%(18/34),亦高于对照组的30.6%(11/36),P=0.023。结论:5-FU按时辰低剂量节律式持续输注联合低剂量DDP治疗中晚期食管癌疗效确切,且耐受性好,尤其对于化疗复治者更具优势,值得推广应用。
Objective: To evaluate the short-term efficacy and tolerability of 5-fluorouracil (5-FU) in treatment of advanced esophageal cancer by continuous low-dose rhythm infusion. Methods: The patients with esophageal cancer were divided into CIV treatment group (experimental group) and conventional chemotherapy group (control group). Experimental group of 34 patients: cisplatin (DDP) 10mg, d1 ~ d5, d8 ~ d12; 5-FU375mg, CIV, 22:00 ~ 10:00, d1 ~ d14, or combined with paclitaxel 90mg, d1, d8. The control group of 36 patients: DDP per cycle, the total amount of 100 ~ 120mg, points 4 ~ 5d; lofloxacin 100mg, d1 ~ d5 (5-FU before); 5-FU750mg, CIV, d1 ~ d5; Every 21 days for a cycle, after two cycles evaluation of efficacy and tolerance. Results: 70 patients were evaluable, the total effective rate (CR + PR) was 44.3% (31/70). The effective rate of chemotherapy in the experimental group was 48.0% (12/25), which was higher than that in the control group (2/15) (χ2 = 5.98, P <0.05). The increase rate of KPS in experimental group was 52.9% (18/34), also higher than that in control group (30.6%, 11/36), P = 0.023. Conclusions: 5-FU continuous infusion of low-dose rhythm and continuous low-dose DDP in the treatment of advanced esophageal cancer has definite curative effect and is well tolerated, especially for the treatment of rheumatoid arthritis, which is worth popularizing and applying.