草酸铂联合方案治疗晚期胃肠道癌的分析

Oxaliplatin in combination with HCPT and 5-Fu in the treatment of advanced gastrointestinal tract cancer

目的 观察草酸铂(Hoxa)联合羟基喜树碱(HCPT)、氟脲嘧啶(5-Fu)方案治疗晚期胃癌、结直肠癌的近期疗效和不良反血。方法 化疗方案分别为:胃癌用Hoxa 130 mg/m2 d1,甲酰四氢叶酸钙(LV)200 mg/m2 d1-d3,5-Fu 400mg/m2,随后600mg/m2 d1-d3、羟基喜树碱(HCPT)6 mg/m2 d1-d5;肠癌用Hoxa 130 mg/m2 d1,LV 200 mg/m2 d1-d5,5-Fu 500 mg/d d1-d5,HCPT 6 mg/m2 d1-d5。 每3-4周为1周期,2个周期及以上判定疗效,并观察不良反应。结果 30例中完全缓解(CR)0,部分缓解(PR)11例,总有效率(CR+PR)36％,缓解期为3-10个月(中位5.5个月),疾病进展时间2-13个月(中位7个月)。不良反应主要为轻度血液学异常、恶心呕吐和外周感觉神经异常。结论 Hoxa、HCPT和5-Fu联合方案治疗晚期胃癌疗效理想,毒副作用小;对复治性结直肠癌疗效欠佳。

Objective To evaluate clinical efficacy and toxicities of homemade oxaliplatin in combination with hydroxycamptothecin (HCPT) and 5-fluornuracil (5-Fu) in the treatment of advanced gastrointestinal tract cancer. Methods A total of 30 patients with gastrointestinal tract cancer were treated with combined chemotherapy based on homemade oxaliplatin. The clinical efficacy and toxicities were evaluated according to WHO criteria. Results There was no complement response (CR) , but partial response (PR) was achieved in 11 cases, and the overall response rate was 36%. The response period was 3 to 10 months (median, 5.5 months) , and the time to progress (TTP) was 2 to 13 months (median, 7 months). The side effects were mild or moderate. Conclusion The regimen of homemade oxaliplatin in combination with HCPT and 5-FU is effective for advanced gastric cancer with tolerable side effects, but it may not be good for colon-rectal cancer with repeated chemotherapy.