草酸铂加醛氢叶酸/5-氟尿嘧啶48h持续静脉滴注双周疗法治疗晚期直肠癌

Clinical study on the treatment of advanced colorectal cancer with oxaliplatin combined with regimen LF 48 hours of biweek schedule

目的观察草酸铂(L-OHP)与CF/5-FU48h持续静脉滴注双周疗法治疗晚期直肠癌疗效及不良反应。方法经病理证实的55例晚期直肠癌患者随机进入研究/对照组。治疗方案:A组草酸铂(L-OHP)+CF/5-FU;B组CF/5-FU,两组均2周为1个周期。结果经过2个周期化疗,A组缓解率33·33%(9/27),B组缓解率21·43%(6/28),A组缓解率高于B组。治疗中无疾病进展及治疗相关死亡,胃肠道反应及骨髓抑制均为轻中度,差异无显著意义。A组周围神经感觉障碍为74·0%(20/27),为轻中度可逆;B组为17·86%(5/28),两组间差异有显著意义(χ2=17·5333,P<0·001)。结论草酸铂+CF/5-FU48h持续静脉滴注双周疗法治疗晚期直肠癌疗效高,不良反应轻,有希望成为最有效的治疗方案。

Objective To assess the anti-tumor efficacy and safety of chemotherapy pump 48-hours continuous infusion treatment combined 5-fluorouracil with bi-weekly high-dose leucovorin and oxaliplatin for colorectal cancer. Methods 55 patients of advanced colorecral cancer were randomly divided into group A and B. Group A were treated with oxaliplatin with hi-weekly high-dose leucovorin and 5-fluorouracil chemotherapy pump 48-hours continuous infusion. Group B were treated with regimen LF 48 hours. All enrolled patients received two cycles of treatment. Results The effective rates of these two groups showed no marked difference （ group A 33.33 %, group B 21.43% ）.Bone marrow suppression and nausea, vomiting had significant differences between two regimens. The rate of peripheral neurilemmitis response was 74.0% in group A and 17.86% in the group B（x^2= 17. 5333, P〈0.001）. Conclusion Oxaliplatin with 5-fluorouracil and high-dose leucovorin is a high response regimen for advanced colorectal cancer with mild toxicity,which can be practiced safely.