OFL方案治疗晚期胃癌的临床观察

Clinical observation on treatment of advanced gastric cancer with OFL regimen

目的观察亚叶酸钙（CF）、氟尿嘧啶（5-Fu）持续输注加草酸铂（OXA）组成的OFL方案治疗晚期胃癌的近期疗效及毒副作用.方法经病理证实的晚期胃癌52例,采用OXA 130 mg/m^2,静滴2 h,第1天;CF 100 mg/m^2,静滴,2 h后推注5-Fu 400 mg/m^2,后续5-Fu 600 mg/m^2,静脉持续输注22 h,第2,3天.21 d为一周期,3个周期评定疗效.结果入组观察52例,其中行原发灶切除者20例,未切除者32例,可评价疗效者52例,其中CR率为11.5%（6/52）,PR率34.6%（18/52）,总有效率46.1%（24/52）.不良反应：白细胞减少Ⅰ～Ⅱ度发生率34.6%（18/52）,Ⅲ～Ⅳ度9.6%（5/52）;Ⅰ～Ⅱ度血小板减少发生率11.5%（6/52）,Ⅲ度血小板减少1.9%（1/52）;胃肠道反应发生率为28.8%（15/52）;口腔黏膜炎发生率5.8%（3/52）;神经系统毒性发生率51.9%（27/52）.结论氟尿嘧啶连续输注的OFL方案治疗晚期胃癌疗效较高,不良反应轻微,患者可以耐受.

Objective To evaluate the efficacy and safety of OXA-LV-5-Fu regimen in treatment of patients with advanced/metastatic gastric cancer. Methods OXA 130 mg/m^2 iv 2 hr dl ,LV 100 mg/m^2 iv 2 hr followed by 5-Fu 400 mg/m^2 iv bolus and 5-Fu 600 mg/m^2 iv 22 hr d2,3. Twenty-one days constituted one cycle and the efficacy was evaluated after 3 cycles. Results Fifty-two patients entered into the study. Patients with primary tumours resected or non-resected were 20 and 32 respectively. Fifty-two patients were evaluable for clinical response. Six patients achieved CR（ 11.5% ） and 18 PR （34.6%）, with ORR being 46.1%. Toxicity： leukopenia was observed in 44.2% of the patients ,but grade Ⅲ-Ⅳ of it was found in 9.6%. Grade Ⅰ-Ⅱ thombocytopenia occurred in 11.5% of the patients, while grade Ⅲ occurred in 1.9%. The incidence of alimentary tract reaction was 28.8% and that of mucositis was 5.8%. Nervous system toxicity occurred in 51.9%. Conclusions OFL regimen has relatively high response rate in patients with advanced gastric adenocarcinoma. The toxicity is slight and can be well tolerated.