2022 年第 4 期 第 17 卷

氟尿嘧啶联合奥沙利铂或顺铂对晚期食管癌患者的临床疗效 

Clinical efficacy of fluorouracil combined with oxaliplatin or cisplatin on patients with advanced esophageal cancer 

作者：马金鑫1冯谢敏2宋炜1马军伟1

英文作者：Ma Jinxin1， Feng Xiemin2， Song Wei1， Ma Junwei1

单位：1延安大学附属医院消化科，延安716000；2延安大学附属医院肿瘤科一病区，延安716000

英文单位：1Department of Gastroenterology Yan′an University Affiliated Hospital Yan′an 716000 China; 2 First Ward Department of Oncology Yan′an University Affiliated Hospital Yan′an 716000 China

关键词：晚期食管癌；氟尿嘧啶；奥沙利铂；顺铂

英文关键词：Advancedesophagealcancer;Fluorouracil;Oxaliplatin;Cisplatin

• 摘要：

• 目的 探讨氟尿嘧啶联合奥沙利铂或顺铂对晚期食管癌患者的临床疗效。方法 选取延安大学附属医院2018年3月至2019年8月收治的晚期食管癌患者92例,应用随机数字表法分为对照组和观察组，各46例。对照组给予氟尿嘧啶联合顺铂治疗,观察组给予氟尿嘧啶联合奥沙利铂治疗；2组均以21 d为1个化疗周期，持续化疗3个周期。比较2组治疗前后血清肿瘤标志物、血管新生指标和免疫功能指标水平，近期临床疗效、生存率和不良反应发生率。结果 治疗3个周期后，2组血清癌胚抗原、糖类抗原19-9、转化生长因子β1、血管内皮生长因子和CD+8水平均低于治疗前且观察组均低于对照组，血清CD+3和CD+4水平均高于治疗前且观察组均高于对照组（均P＜0.05）。观察组客观缓解率和疾病控制率与对照组比较差异均无统计学意义（均P＞0.05），治疗24个月生存率高于对照组［67.4%(31/46)比45.7%（21/46）］(P＜0.05)。观察组化疗期间恶心呕吐、腹泻、肝肾功能损伤和血小板减少发生率均低于对照组，外周神经毒性发生率高于对照组（均P<0.05）。结论 氟尿嘧啶联合奥沙利铂或顺铂治疗晚期食管癌患者近期疗效相当，但氟尿嘧啶联合奥沙利铂治疗方案在调节血清癌胚抗原、糖类抗原19-9水平和提高远期生存率等方面效果更佳。

• Objective To investigate the clinical efficacy of fluorouracil combined with oxaliplatin or cisplatin on patients with advanced esophageal cancer. Methods Totally 92 patients with advanced esophageal cancer admitted to Yan′an University Affiliated Hospital from March 2018 to August 2019 were enrolled. They were randomly divided into control group and observation group, with 46 cases in each group. The control group was treated with fluorouracil combined with cisplatin, and the observation group was treated with fluorouracil combined with oxaliplatin. Both groups took continuous chemotherapy for 3 cycles with 21 d as a cycle. The levels of serum tumor markers, angiogenesis indexes and immune function indexes before and after treatment, short-term clinical efficacy, survival rate and incidence of adverse reactions were compared between the two groups. Results After 3 courses of treatment, serum levels of carcinoembryonic antigen, carbohydrate antigen 19-9 and transforming growth factor-β1, vascular endothelial growth factor, and CD+8 in both groups decreased, and those in the observation group were lower than those in the control group; serum levels of CD+3 and CD+4 in both groups increased, and those in the observation group were higher than those in the control group(all P<0.05). There were no significant differences in objective remission rate and disease control rate between the two groups (both P>0.05). The 24-month survival rate in the observation group was higher than that in the control group ［67.4%(31/46) vs 45.7%(21/46)］(P<0.05). The incidence of nausea, vomiting, diarrhea, liver and kidney function injury and thrombocytopenia in the observation group were lower than that in the control group, and the incidence of peripheral neurotoxicity was higher than that in the control group (all P<0.05). Conclusions The fluorouracil combined with oxaliplatin or cisplatin have same short-term efficacy on patients with advanced esophageal cancer. However, the former combined scheme has better effect on regulating serum levels of carcinoembryonic antigen and carbohydrate antigen 19-9, and improving the long-term prognosis.