氟尿嘧啶、阿霉素和顺铂/奈达铂作为新化疗方案治疗晚期食管癌的疗效和毒性

作     者：Kosugi S.- I. Kanda T. Nakagawa S. 赵菊辉 

作者机构：Division of Digestive and General Surgery Niigata University Graduate School of Medical and Dental Sciences 1- 757 Asahimachi- dori Niigata City 951- 8510 Japan 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2005年第1卷第12期

页      面：57-57页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：晚期食管癌 奈达铂 尿嘧啶 食管切除术 淋巴结转移 肿瘤复发 肿瘤进展 临床分期 存活时间 存活期 

摘      要：Objective. Patients with advanced esophageal carcinoma including clinical T4 tumor, extensive lymph node metastasis, or intramural metastasis have a dismal prognosis, despite recent multimodality treatments. The aim of this study was to evaluate the efficacy and toxicity of neoadjuvant chemotherapy using fluorouracil, doxorubicin, and cisplatin or nedaplatin (FAP/N)- in these patients. Material and methods. Twenty- six patients were enrolled in this study. The first 9 patients received 600 mg/m2 fluorouracil on days 1- 7 and days 29- 35, and 30 mg/m2 doxorubicin and 60 mg/m2 cisplatin on days 1 and 29 (FAP). The next 17 patients received modified FAP, in which 50 mg/m2 nedaplatin was given instead of cisplatin (FAN). Results. Grade 3 or 4 toxicities developed in 6 patients (23.1% ) during chemotherapy, but there was no discontinuation of treatment. The clinical response rate was 46.2% . Twenty- one patients (80.8% ) underwent esop- hagectomy, and R0 resection was achieved in 16 patients (61.5% ). The 1- year survival rates of 26 patients, 21 patients with resectable tumor, 16 with R0 resection, and 12 clinical responders, were 31.3% , 32.1% , 33.3% , and 45.5% , respectively, each with a median survival time of 9 months. The median progression- free survival time of 26 patients was 6 months; in 16 patients with R0 resection progression- free survival was 6.5 months. There was no correlation between the recurrence pattern and tumor spread before treatment. Conclusions. FAP/N was found to have acceptable toxicities and the ability to control locoregional tumors, but made little contribution to patient survival. The efficacy of this treatment for patients with advanced esophageal carcinoma, however, may not yet be apparent.