L-OHP联合5-FU/LV二线治疗晚期大肠癌2周方案与3周方案的临床比较

Comparison of 2-week regimen and 3-week regimen based on oxaliplation plus 5-flurouracil and leucovorin as the second line in the treatment of advanced colorectal carcinoma

目的：比较奥沙利铂（L-OHP）联合氟尿嘧啶/亚叶酸钙（5-FU/LV）的2周方案与3周方案二线治疗晚期结直肠癌的临床疗效及不良反应.方法：晚期复治的结直肠癌病例,A组22例,予L-OHP 85mg/m^2,d1,静脉滴注3小时,同时或之后予CF 200mg/m^2,静脉滴注2小时,续5-FU 400mg/m^2,静脉推注,600mg/m^2持续静脉滴注22小时,次日重复CF与5-FU.每2周重复1次,每2次计为1周期.B组24例,予L-OHP 130mg/m^2,d1,静脉滴注3小时,CF 200mg/m^2,静脉滴注2小时,续5-FU 375～425mg/m^2静脉滴注4～6小时,连用5天.每3周重复1次,每次计为1周期.结果：A、B两组分别有21例和23例可评价,RR分别为19.05%和8.70%,中位TTP分别为4.0和3.0月,两组病例不良反应发生率相似,主要表现为消化道反应、神经系统毒性和脱发.结论：L-OHP联合5-FU/LV的2周方案在临床疗效方面优于3周方案.

Objective：To compare the difference between 2-week and 3-week regimens in clinical effect and side effects of oxaliplatin with 5-flurouracil and leucovorin in the treatment of advanced colorectal carcinoma as the second line. Methods：Retreated patients with advanced colorectal carcinoma were devided into two groups ,22 cases in group A were given intravenously oxaliplatin 3-hour drip with 85mg/m^2 on day 1, leucovorin 2-hour drip simultaneously or afterwards with 200mg/m^2, then ,5-flurouracil 400mg/m^2,in bolus ,600mg/m^2 continuous infusion for 22 hours, leucovorin and 5-flurouracil were repeated on day 2. The regimen was repeated every 2 weeks and 4 weeks was a cycle,24 cases in group B were given oxaliplatin 130mg/m^2 over 3 hours infusion on day 1, leucovorin 200mg/m^2 infusion over 2 hours from day 1 to day 5 and 5-flurouracil 375-425mg/m^2 for 4-6 hours as the same way. The regimen was repeated every 3 weeks,ie,one cycle. Evaluated the data from the 2 groups. Results：21 and 23 patients respectively in groups A and B could be evaluated,RR were 19. 05% and 8. 70% ,Median TTP were 4.0 and 3.0 months respectively. Side effects were similar in two groups, mainly in digestive system, nerve system and alopecia. Conclusion：The clinical efficacy of oxaliplatin plus 5-flurouracil and leucovorin in 2-week regimen is better than that of 3-week regimen.