OLF方案与LFP方案治疗晚期胃癌的临床观察

Clinical Observation of L-OHP+LF Regimen and PDD+LF Regimen in Treatment of Advanced Gastric Cancer

目的 观察OLF方案（L-OHP＋LV＋5-Fu）与LFP方案（PDD＋LV＋5-Fu）治疗晚期胃癌的疗效和毒副作用。方法 54例晚期胃癌患者随机分为OLF组和LFP组。采用L-OHP 130mg／m^2 静滴2h第1天；LV 100mg／m^2 静滴2h第1～5天，5-Fu 500mg／m^2 静滴4h第1～5天（OLF方案）。PDD 25mg／m^2 静滴第1～3天，LV 100mg／m^2静滴2h第1～5天，5-Fu 500mg／m^2 静滴4h第1～5天（LFP方案）。两方案均21天或28天为一周期。2方案均化疗2周期以上评价疗效。结果 近期有效率OLF方案组44％，LFP方案组41．3％（P〉0．05），中位生存期OLF组10．2个月，LFP组9．8个月；1年生存率OLF组70．9％，LFP组68．3％（P〉0．05）．Ⅲ～Ⅳ度恶心呕吐OLF组4％，LFP组24．1％，（P〈0．05），Ⅲ～Ⅳ度白细胞下降OLF组4％，LFP组24．1％，（P〈0．05）。结论 两方案近期有效率、1年生存率、中位生存期相当，而OLF组毒副作用较LFP组相对较轻。

Objective To investigate the effect and toxicity of advanced gastric cancer patients with L-OHP ＋ LF regimen and PDD ＋ LF regimen. Methods 54 patients with advanced gastric cancer were randomized into two groups（OLF and LFP）. Group OLF was treated with L-OHP ＋ LF regimen（L-OHP 130mg/m^2 iv infusion for 2 hours on day 1 ; LV 100mg/m^2 iv infusion for 2 hours from day 1 to 5 ; 5-Fu 500mg/ m^2 iv infusion 4 hours from day 1 to 5） . Group LFP was treated with PDD ＋ LF regimen（PDD 25mg/m^2 iv infusion from day 1 to 3 ; LV 100mg/ m^2 iv infusion for 2 hours from day 1 to 5; 5-Fu 500mg/m^2 iv infusion for 4 hours from day 1 to 5） .The cycle was 21 or 28 days. The patients were randomized to receive one of the two regimens for two cycles. Results Early response was rate 44% （OLF） and 41 . 3 % （LFP） （ P 〉 0.05 ） . The median survival time was 10.2 months （OLF） and 9.8 months （LFP） （ P 〉 0.05）. The 1-year survival rate was 70.9 % （OLF） and 68.3 % （LFP） （ P 〉 0.05 ）. Grade Ⅲ - Ⅳ nausea and vomiting was 4 % （OLF） and 24.1% （LFP） （ P 〈 0.05 ） . Grade Ⅲ - Ⅳ enutropenia was 4 % （OLF） and 24.1% （LFP） （ P 〈 0.05） . Conclusions There was no significant difference in response rates,the median survival and the 1-year survival rates between the two regimens, but the OLF Group was less toxic than the LFP Group.