氟尿嘧啶/亚叶酸联合奥沙利铂或紫杉醇治疗晚期胃癌——临床随机对比研究

Fluorouracil/leucovorin combined with oxaliplatin or paclitaxel in patients with advanced gastric cancer

目的 :比较氟尿嘧啶 /亚叶酸 (5 FU/FA)联合奥沙利铂与 5 FU/FA联合紫杉醇治疗晚期胃癌的近期疗效和毒副反应。方法 :4 0例进展期胃癌患者随机分成两组 ,5 FU/FA联合奥沙利铂组 (A组 ) 2 0例 ,70 .0 %为复治患者 ,5 FU/FA联合紫杉醇组 (B组 ) 2 0例 ,5 5 .0 %为复治患者 ,转移部位包括肝、淋巴结、腹腔、腹壁等。结果 :两组患者各有 2 0例可评价疗效 ,A组CR 2例 ,PR 7例 ,有效率 (CR +PR) 4 5 .0 % ,B组PR 9例 ,有效率 4 5 .0 %。A组有 2 0例评价毒性反应 ,主要为骨髓抑制、外周神经毒性、消化道反应、肝功能损害 ;B组有 2 0例可评价毒性反应 ,主要为骨髓抑制、肝功能损害。结论 :5 FU/FA联合奥沙利铂与联合紫杉醇治疗晚期胃癌疗效相当 ,毒性反应可耐受。两者相比 ,联合奥沙利铂具有用药方便 。

Purpose:To compare with the efficacy in the immediate effects and toxicities on patients with advanced gastric cancer treated with 5-fluorouracil (5-FU) and leucovorin (LV) combined with oxaliplatin or paclitaxel. Methods:Forty patients with advanced gastric cancer, whose metastases to organs or sites included liver, lymphy node, abdominal cavity, abdominal wall, etc, were enrolled in this study, and was randomly divided into two groups (A and B groups). The A group of 20 patients (70% of them were retreated patients) were treated with a combination of oxaliplatin, leucovorin(LV) and 5-fluorouracil(5-FU) continuous infusion regimen. The B group of 20 patients (55% of them were retreated patients) were treated with a combination of paclitaxel, leucovorin (LV) and 5-fluorouracil(5-FU) continuous infusion regimen. Results:Of the 40 evaluable patients, there were two complete responses and seven partial responses (response rate 45%) in the A group, and nine partial responses (response rate 45%) in the B group. All patients were evaluable for toxicities. The most common toxicities were bone marrow depression,peripheral neuropathy,digestive tract toxicities and liver function damage in the A group. The most common toxicities were bone marrow depression and liver function damage in the B group. Conclusions:These two regimens (5-fluorouracil and lcucovorin combined with oxaliplatin or paclitaxel) showed good efficacy and acceptable toxicities in advanced gastric cancer patients, and the 5-fluorouracil and leucovorin combined with oxaliplatin regimen may have some virtues, such as economics, convenience of medication and less serious toxicities.[