中低剂量醛氢叶酸与氟脲嘧啶联合化疗临床观察比较

Clinical study of combined chemotherapy with 5-Fluorouracil plus middle-dose or low-dose Leucovorin

目的 对比中低剂量醛氢叶酸 (CF)与氟脲嘧啶 ( 5 Fu)联合化疗的近期疗效和毒副反应。同时比较PLF与ELF两方案的疗效和毒性反应。方法 随机采用不同剂量CF/5 Fu +顺铂 (DDP)或足叶乙甙 (VP16)联合化疗方案治疗恶性肿瘤 117例。结果 中、低剂量CF联合化疗有效率分别为 38.0 %和 44.7%(P >0 .0 5 ) ,两组主要毒性反应均以白细胞减少、恶心呕吐、口腔炎和脱发为主 ,均无显著性差异。PLF与ELF方案的有效率分别为 44.0 %和 31.8%(P >0 .0 5 ) ,毒副反应亦为骨髓抑制、恶心呕吐及口腔炎 ,其Ⅲ～Ⅳ级白细胞减少、血小板减少和口腔炎的发生率分别为 11.4%与 44.3%、0 .9%与 5 .6 %及 3.9%与 11.1%(P <0 .0 5 ) ,有统计学差异。结论 低剂量CF与 5 Fu +DDP联合化疗是治疗鼻咽癌和胃肠道癌比较安全、有效、经济的化疗方案。

Objective To compare the therapeutic effect and toxicity of middle-dose or low-dose Leucovorin(CF) plus 5-Fu,and of PLF regimen with ELF regimen in tumor patients.Methods One hundred and seventeen cancer patients were treated with various-dose CF/5-Fu plus Cisplatin (DDP) or Etoposide(VP16) at random.Results The response rates of middle-dose CF group and low-dose CF group were 38.0% and 44.7%(P>0.05),respectively.The major toxicities of both groups were leukopenia,nausea,vomiting and oral mucositis.The response rates of PLF regimen and ELF regimen were 44.0% and 31.8%(P>0.05),respectively. GradeⅢ and Ⅳ leukopenia,thrombocytopenia and oral mucositis was fewer in PLF group than in ELF group (P<0.05).Conclusion It is suggested that low-dose Leucovorin plus 5-Fu and DDP is a safe,effective and economical in treating nasopharyngeal carcinoma and gastrointestinal carcinoma.