草酸铂氟脲嘧啶和叶酸组成的两种方案治疗晚期大肠癌

The Studies on Two Regimens Composed of Oxaliplatin,Fluorouracil, and Leucovorin for Patients with Advanced Carcinoma of Large Intestine

目的:观察两种剂量的叶酸(citrovorum factorCF20mg/m2、200mg/m2)、草酸铂(OxaliplatinL-OHP130mg/m2、85mg/m2),两种给药方法的氟脲嘧啶(5-FU每天滴注2小时、持续滴注)组成的两种方案,分别治疗晚期大肠癌的临床疗效及不良反应。方法:将晚期大肠癌患者按照治疗方案不同,随机分为A、B两组,对两组临床疗效及毒副反应进行对比观察。结果:A组有效率为45.3%(24/53),中位生存期17.6个月;B组有效率为25.5%(13/51),中位生存期12.9个月。两组疗效比较有统计学意义(P<0.05)。结论:对于晚期大肠癌,草酸铂联合CF和5-FU持续滴注化疗的疗效优于草酸铂联合CF和5-FU间断滴注。

Objective： To observe the difference for clinical efficacy and side effect in advanced colorectal carcinoma between two different chemotherapeutic regimens consisted of 5-Fu, leucovorin （citrovorum factor CF） and oxaliplatin （L-OHP）. Methods： A total of 104 patients with metastases of colorectal cancer were enrolled and randomly assigned to 2 treatment schedules. In schedule A, treatment courses consisted of L-OHP （85 mg/m^2 day 1, venous infusion）, CF （200 mg/m^2 day 1 by 2 hours venous infusion） and 5-Fu （500 mg bolus, followed by 5-Fu 3000 mg/m^2 continous venous infusion 46 hours, dayl）, repeated every 14 days at least 6 courses. In schedule B, treatment courses consisted of L-OHP （130 mg/m^2 day l, venous infusion）, CF （20 mg/m^2/d, day 1-5, bolus infusion） and 5-Fu （425 mg/m^2/d, bolus infusion, day1-5）, repeated every 28 days at least 3 courses. The clinical efficacy and side effect were compared based on the standard of WHO. Results： The response rate of 45.3% and the median survival time of 17.6 months were observed in group A. The results were significantly superior to those observed in group B： 25.5% and 12.9 months （P 〈 0.05）. Conclusion： In chemotherapy of advanced colorectal carcinoma, the regimen composed of L-OHP and CF, as well as continuous infusion 5-Fu is superior than that comprised of L-OHP and CF and interrupt instillation 5-Fu.