奥沙利铂联合氟尿嘧啶和亚叶酸钙治疗晚期胃癌的研究

Clinical Study of Oxaliplatin plus 5-FU/CF in Treatment of Advanced/Metastatic Gastric Cancer

目的 :研究奥沙利铂联合氟尿嘧啶和亚叶酸钙治疗进展及转移性胃癌的疗效和毒副反应。方法 :采用奥沙利铂 130mg/m2 ,静滴 2小时 ,第 1天 ;亚叶酸钙 2 0 0mg/m2 ,静滴 2小时 ,第 1～ 5天 ;氟尿嘧啶 30 0mg/m2 ,静滴 4小时 ,第 1～ 5天(亚叶酸钙滴完后用 ) ;2 1天或 2 8天为 1周期 ,行 4周期治疗后判定疗效。结果 :其中完全有效 3例 (8 8% ) ,部分有效 11例(32 4 % ) ,无变化 14例 (4 1 2 % ) ,进展 6例 (17 6 % ) ,总有效率为 4 1 2 % ,中位总生存期 9个月。毒副反应以骨髓抑制、感觉性神经毒性为主 ,其中白细胞减少占 4 4 1% ,血小板减少占 4 1 2 %。感觉性神经毒性占 82 4 % ,无化疗相关死亡。结论 :奥沙利铂联合氟尿嘧啶、亚叶酸钙治疗晚期胃癌疗效肯定 ,毒副反应能耐受 ,值得进一步试用。

Objective:To study the response and t ox icity of the regimen of oxaliplatin combined with fluorouracil and calcium folin ate in the treatment of adavanced/metastatic gastric cancer.Methods:Thirty-four patients with adavanced/metastatic g astric cancer received chemotherapy of regimen:oxaliplatin 130mg/m 2 2 hours iv on day 1,calcium folinate 200mg/m 2 iv 2 hours on days 1 to 5,followed by fluorouracil 300mg/m 2 iv 4h on days 1 to 5,three or four weeks as one cycle.Efficacy was evaluated at 4 cycles.Results:Three patients achieved CR(8.8%),13 PR(32.4%),1 4 NC(41.2%) and 6 PD(17.6%).Overall response rate was 41.2% and median overal l suvival was 9 months.The major toxicity included myelo suppression and neuro- sensory toxicity,leucopenia was observed in 44.1% of the patients,thrombocytope nia was in 41.2%,neuro-sensory toxicity was in 82.4%.There were no any death events during treatment.Conclusion:This study shows that the regimen of oxaliplat in combined fluorouracil and calcium folinate is effective and tolerable in adav anced/metastatic gastric cancer.