含草酸铂方案治疗晚期胃癌近期疗效分析——附18例报告

目的 :观察甲酰四氢叶酸钙 (CF)与 5 氟脲嘧啶 (5 FU)合用草酸铂 (OXA)和表阿霉素 (EPI)作为一线方案治疗晚期胃癌的疗效和毒性。方法 :共收治Ⅳ期胃癌 18例 ,其中低分化腺癌 10例 ,中分化腺癌 3例 ,黏液腺癌 3例 ,印戒细胞癌 2例。初治 15例 ,复治 3例。方案包括CF 15 0mg m2 静脉滴入 2h ,第 1～ 5天 ,5 FU 375mg m2 持续静脉滴入 ,连续 12 0h ;国产草酸铂 80～ 10 0mg m2 静脉滴入 2h ,第 1天 ;EPI 60mg m2 静脉推注 ,第 1天 ;3～ 4周为 1个周期。结果 :CR 1例 ,PR 10例 ,NC 5例和PD 2例 ,总有效率 (CR PR)为 61 1% (11 18)。中位缓解期 8个月 ,中位生存期 11个月 ,1年生存率为4 5 %。主要毒副反应为骨髓抑制和脱发。骨髓抑制为剂量限制性毒性 ,其中Ⅲ～Ⅳ度占 2 2 2 % ,需要配合G CSF的应用。 1例发生Ⅰ度腹泻和 1例发生Ⅰ度外周神经病变 ,未作特殊处理。结论 :LFOE方案是治疗晚期或转移性胃癌高效且较安全的方案

Leucovorin and 5-Fluorouracil with Oxaliplatin and Epidoxorubicin as Firs Tline Treatment in Advanced Gas-tric Cancer

Objective To observe the respose and tolerance to the regimen of leucovorin and 5 fluorouracil with oxaliplatin and epidoxorubicin (LFOE) as first line treatment in advanced gastric cancer.Methods Eigthteen patients with advanced gastric cancer received chemotherapy of LFOE regimen (Leucovorin 150 mg/m 2 iv d 1 d 5 ,5 FU 375 mg/m 2 continuous infusion 120 hours,Oxaliplatin 80-100 mg/m 2 iv d 1 and Epidoxoruvicin 60 mg/m 2 iv d 1,q 21-28 d).Results The overall response rate was 61 1% (11/18) and complete response rate was 5 6% (1/18),the partial response rate was 56 5% (10/18).The main toxity was myelosuppression and alopecia.Leukopenia was observed in 83 3% of the patients,but grade 3 and 4 in 22 2%.Anemia and throbopenia were observed in 60 2% and 65 4% of the patients,but in grade 3 and 4 is 22 2% and 16 7% respectively,temporary hair loss may occure (alopecia) in 100%.Other side effects were uncommon.Conclusion This study shows that the regimen of LFOE is effective and tolerable for treatment of advanced gastric cancer.