氟尿嘧啶/亚叶酸钙+紫杉醇联合化疗双周方案治疗晚期胃癌

Biweekly Regimen of High Dose of Leucovorin, 5-Fluorouracil, and Paclitaxel for Patients with Advanced Gastric Cancer

背景与目的:近来有临床研究显示紫杉醇(paclitaxel,PTX)可用于治疗胃癌,与5-氟尿嘧啶(5-fluorouracil,5-FU)联合治疗晚期胃癌疗效显著,不良反应轻。本研究观察5-FU/亚叶酸钙(leucovorin,CF)+PTX联合化疗双周方案治疗晚期胃癌的临床疗效和不良反应。方法:采用高剂量5-FU/CF+PTX深静脉输注方案(CF200mg/m2,静滴2小时,第1天;5-FU500mg/m2,静脉推注,第1天;5-FU1500mg/m2,静滴46小时;PTX90mg/m2,静脉输注3小时,第1天),化疗方案以每两周为1周期,重复4周期后评定疗效。结果:全组20例均可评价疗效,总有效率为65.0%(13/20),其中完全缓解(CR)率为10.0%(2/20),部分缓解率为55.0%(11/20)。无治疗相关死亡,主要不良反应为口腔炎、手足综合征和脱发。结论:5-FU/CF+PTX联合化疗双周方案治疗晚期胃癌缓解率较高、不良反应可耐受,是治疗晚期胃癌安全有效的化疗方案。

BACKGROUND &OBJECTIVE: Clinical study showed that paclitaxel (PT X) may be used to treat gastric cancer. The combination of PTX and 5-fluorouracil (5-FU) is effective, and safe in treating advanced gastric cancer. This study was to investigate efficacy of biweekly regimen of high dose of leucovorin (CF), 5-FU, and PTX on advanced gastric cancer, and its toxicities. METHODS: Twenty patients with advanced gastric cancer received biweekly regimen of CF/5-FU/PTX (200 mg/m2 of CF, intravenous infusion for 2 h, day1; 500 mg/m2 of 5-FU, intr avenous injection, day1; 1 500 mg/m2 of 5-FU, intravenous infusion for 46 h, da y1, 2; 90 mg/m2 of PTX, intravenous infusion for 3 h,day1). Efficacy, and toxici ties were evaluated after 4 cycles. RESULTS: Total response rate was 65.0%(13/ 20)with 2 (10.0%) cases of complete remission (CR), and 11 (55.0%) cases of p artial remission (PR). No treatment-related death occured. Stomatitis, hand-fo ot syndrome, and loss of hair were main toxicities. CONCLUSION: Biweekly regimen of high dose of CF, 5-FU, and PTX may achieve a high response rate with tolera ble toxicities in patients with advanced gastric cancer.