多西他赛为主的两药与三药化疗在食管癌术后的疗效分析

宋少伟，王　勇，赵渭东，卜智斌，张永辉



多西他赛为主的两药与三药化疗在食管癌术后的疗效分析

宋少伟，王勇，赵渭东，卜智斌，张永辉

目的观察以多西他赛为主的两药与三药化疗方案在食管癌术后化疗的疗效及不良反应发生情况。方法将我院2010年1月～2014年12月收治的食管癌根治术后患者140例随机分为两药组70例和三药组70例，两药组采用多西他赛注射液+卡培他滨片联合用药，三药组采用多西他赛注射液+卡培他滨片+奥沙利铂注射液联合用药。治疗4个疗程后，对两组治疗效果、不良反应发生情况进行比较。结果三药组临床总有效率为64.3%，两药组为61.4%，两组差异无统计学意义（P＞0.05）；两组均有不同程度的不良反应发生，其中三药组Ⅲ～Ⅳ度中性粒细胞减少、恶心呕吐及腹泻的发生率（35.7%，24.3%，18.6%）显著高于两药组（17.1%，14.3%，8.6%）（P＜0.05）。结论食管癌术后采用多西他赛为主进行的两药与三药化疗方案对患者疗效无明显差异，但三药化疗方案不良反应发生率较高，故多西他赛联合卡培他滨可作为食管癌术后化疗方案的优先选择。

食管癌；化疗；多西他赛；术后；疗效；不良反应

[Abstract]Objective To observe the curative effects of docetaxel-based two-and three-drug chemotherapies for patients after esophageal cancer operation and the incidence of adverse reactions.Methods 140 patients with esophageal cancer who received radical correction between January 2010 and December 2014 were random ly divided into two-drug group(70 cases)and three-drug group(70 cases).The two-drug group received the treatment with docetaxel injection and capecitabine tablet,while the three-drug receiveded docetaxel injection,capecitabine tablet,and oxaliplatin injection.After 4 courses of treatment,comparison wasmade in the clinical effects and the incidence of adverse reactions between the two groups.Results The clinical total effective rate of the three-drug group was 64.3%,and that of the two-drug group was 61.4%.The differencewas not significant(P＞0.05).Both groups had different degrees of adverse reactions.The incidence ofⅢ-Ⅳgrade neutropenia,nausea and vomiting,and diarrhea in the three-drug group(35.7%,24.3%,and 18.6%)was significantly higher than that in the two-drug group(17.1%,14.3%,and 8.6%)(P＜0.05). Conclusion After the esophageal cancer operation,docetaxel-based two-and three-drug chemotherapies have no significance in clinical effects.However,incidence of adverse reactions in the three-drug group is higher,which means docetaxel combined with capecitabine can be the optimizing choice for the chemotherapy after esophageal cancer operation.

[Keywords]esophageal cancer;chemotherapy;docetaxel;postoperative;curative effect;adverse reaction

食管癌是我国高发的消化道恶性肿瘤，每年因食管癌死亡人数约15万人，严重威胁人类健康[1]。食管癌的治疗方式主要分为外科手术治疗、放射治疗及化学治疗，其中手术治疗是食管癌首选[2]。然而，食管癌术后患者往往发生复发或转移，因此，手术联合放化疗的综合治疗方式成为食管癌治疗的新思路。目前，以多西他赛为主的三药化疗方案已在临床治疗中部分开展，然而与多西他赛为主的两药化疗方案比较，其疗效与不良反应发生情况尚不可知。……