魏 玲, 李苏宜. 铂类药物治疗食管癌的临床研究进展[J]. 中国肿瘤临床, 2010, 37(4): 238-240. DOI: 10.3969/j.issn.1000-8179.2010.04.018
引用本文: 魏 玲, 李苏宜. 铂类药物治疗食管癌的临床研究进展[J]. 中国肿瘤临床, 2010, 37(4): 238-240. DOI: 10.3969/j.issn.1000-8179.2010.04.018
WEI Ling, LI Suyi. Clinical Progress in Platinum-based Chemotherapy for Esophageal Cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2010, 37(4): 238-240. DOI: 10.3969/j.issn.1000-8179.2010.04.018
Citation: WEI Ling, LI Suyi. Clinical Progress in Platinum-based Chemotherapy for Esophageal Cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2010, 37(4): 238-240. DOI: 10.3969/j.issn.1000-8179.2010.04.018

铂类药物治疗食管癌的临床研究进展

Clinical Progress in Platinum-based Chemotherapy for Esophageal Cancer

  • 摘要: 食管癌是我国最常见的恶性肿瘤之一,治疗采用手术、放疗、化疗综合治疗模式。食管癌化疗一直采用铂类药物为基础的联合方案。顺铂治疗食管癌疗效确切,用于新辅助化疗、辅助化疗,同期联合放疗和晚期病例的解救化疗。联合5-FU 的化疗方案在在食管癌同期放化疗、解救化疗中是被认为是标准方案。与顺铂相比,卡铂的肾毒性、胃肠道反应、耳毒性均低于顺铂,治疗食管癌并未显示出更多的优势。奥沙利铂治疗食管腺癌显示出较好的有效率和中位生存期,较顺铂降低了肾毒性和胃肠道反应,但外周神经毒性发生率高。奈达铂治疗食管鳞癌疗效确切,总体治疗效果不劣于含顺铂的联合方案,临床用于晚期食管癌的解救化疗、同期联合放疗等,因具较严重的骨髓抑制,代替DDP 用于食管鳞癌的一线治疗还需更加确凿的循证依据,对食管腺癌疗效尚不清楚。洛铂、5-FU 及亚叶酸钙联合方案治疗晚期食管癌疗效和安全性较好,主要不良反应是可逆性骨髓抑制和胃肠道反应,值得进一步研究。

     

    Abstract: The esophagus carcinoma is one of the most common cancers in China. The therapy modes for esopha-gus carcinoma include surgery, radiotherapy and chemotherapy. Platinum-based combined chemotherapy has always been used in the treatment for esophagus carcinoma. In this article, we reviewed the application of platinum-based chemo-therapy in esophageal cancer in recent years. The efficacy of cisplatin in treating esophageal cancer has been proved. Cis -platin is used in neoadjuvant chemotherapy, adjuvant chemotherapy, concurrent chemo-radiotherapy and salvage chemo-therapy for esophageal cancer. Combined chemotherapy with 5-fluorouracil ( 5-FU) and cisplatin is regarded as the stan-dard regimen for esophageal cancer in concurrent chemoradiotherapy and salvage chemotherapy. Compared with cisplat-in, carboplatin causes lower rate of nephrotoxicity, reactions in the digestive tract and ototoxicity. But carboplatin does not have better effect. Patients with esopohageal adenocarcinoma show good clinical response to oxaliplatin and relatively sat-isfactory median survival. The rate of nephrotoxicity and reactions of digestive tract caused by cisplatin is lower. Oxaliplatin can lead to serious neurotoxicity. The therapeutic efficacy of nedaplatin is as good as that of cisplatin. Nedaplatin is used in concurrent chemoradiotherapy and salvage chemotherapy for esophageal squamous cell carcinoma. Compared with cispla-tin, nedaplatin can result in myelosuppression. Further research is warranted to explore whether nedaplatin can take place of cisplatin as the standard regimen. Lobaplatin combined with 5-fluorouracil ( 5-Fu) and leucovorin (CF) is effective and well tolerated for advanced esophagus carcinoma. The major toxicities noted are reversible bone marrow suppression and gastrointestinal tract reaction.

     

/

返回文章
返回