Chemotherapy regimen for esophageal cancer
I. DDF+5-Fu
Drug
Dose
Route of administration
Dosing time
Cisplatin DDP
20mg/m2
Intravenous drip
Day 1 ~ 5
Fluorouracil 5-Fu
500mg/m2
Intravenous drip
Day 1 ~ 5
Repeat every 3 ~ 4 weeks
Precautions.
1, The adverse effects of this regimen are mainly gastrointestinal toxicity, including nausea, vomiting, stomatitis, damage to the gastrointestinal mucosa, and the necessity to apply antiemetic drugs, such as 5-HT3 receptor antagonists.
2, 5-Fu in clinical use, the individual tolerance of large differences, if the patient’s first course of chemotherapy oral mucositis and diarrhea is obvious, the next course of 5-Fu need to reduce the dose.
3.The use of high-dose DDP must be hydrated and diuretic.
4. This regimen is most widely used in esophageal cancer. For patients with locally advanced disease, the efficiency of this regimen is 40%~50%, and both drugs have radiosensitizing effects if administered simultaneously with radiotherapy, and the adverse effects of this regimen are mild.
Second, Paclitaxel+DDP+5-Fu regimen.
Drug
Dose
Route of administration
Administration time
Paclitaxel PTX
175mg/m2
Intravenous drip
Day 1
Cisplatin DDP
80mg/m2
Intravenous drip
Day 1
Fluorouracil 5-Fu
750mg/m2
Intravenous drip
Day 1 ~ 5
Repeat every 4 weeks
Precautions.
1. The adverse effects of this regimen are mainly myelosuppression, but prophylactic G-CSF application is not required. In case of concomitant granulocyte-deficient infection, prophylactic G-CSF application may be considered for the next course of treatment.
2, 5-Fu in clinical use, individual tolerance differences, if the patient’s first course of chemotherapy oral mucositis and diarrhea is obvious, the next course of 5-Fu need to reduce the amount.
3.The use of high-dose DDP must be hydrated and diuretic.
4, The regimen has a clinical efficiency of 48% with a high CR rate of 12%. Overall, the chemotherapy regimen containing PTX has a high efficiency.
5.For recurrent and metastatic esophageal cancer, the purpose of chemotherapy is palliative treatment, which aims to improve the quality of life and/or prolong survival, so the intensity of treatment should not be excessive, and effective patients should be maintained for 4~6 courses of treatment, while patients who are ineffective or failing can be considered to apply new drug composition regimen, and clinical trials can also be considered.
6. Patients treated with concurrent radiotherapy need to pay attention to adverse reactions.