ELF与FAM方案治疗晚期胃癌57例临床分析

The Clinical Analysis of 58 Cases with Advanced Gastric Carcinoma Treated with FAM and ELF Regimen

我科自１９８５年５月至１９９５年３月，用ＥＬＦ及ＦＡＭ方案治疗晚期胃癌５７例，其中ＥＬＦ组２５例，ＦＡＭ组３２例。疗效分别为５６％（１４／２５）和３１．２５％（１０／３２），完全缓解率为１２％（３／２５）和１２．５％（４／３２）。恶心呕吐的Ⅲ级毒性发生率：ＥＬＦ组为０％，ＦＡＭ组为２５％（８／３２）；口腔粘膜Ⅱ级以上毒性发生率：ＥＬＦ组为４４％（１１／２５），ＦＡＭ组为０％；ＥＬＦ组未见心脏毒性，而ＦＡＭ为１２．５％。两者疗效无统计学差异（Ｐ＞０．０１）。恶心呕吐发生率ＦＡＭ方案明显大于ＥＬＦ方案（Ｐ＜０．０２５），而ＥＬＦ组的口腔炎发生率明显高于ＦＡＭ组（Ｐ＜０．００１）。结果表明ＥＬＦ方案更适合于不能耐受强烈化疗或存在基础心脏疾病的进展期胃癌患者。

Fifty seven cases with advanced gastric carcinoma were treated with ELF or FAM regimen from May 1985 to March 1995. The response rate of 25 cases with the ELF was 56%(14/25),and that of 32 cases with the FAM was 31. 25 % (10/32). CR rate was 12% (3/25) and 12. 5% (4/32) respectively. Nausea and vomiting above WHO' S grade Ⅲ occurred in 0case in the FAM group,and & cases (25 % ) in the FAM group, Stomatitis above grade Ⅱ incidence was 44% (11/25) in the ELF and 0% in the FAM. Heart toxicity was not found in the ELF,but incidence was 12. 5% in the FAM. With a statistical analysis,there was not any significant difference in respomse rate. Incidence of nausea and vomiting in the FAM was Higher than that in the ELF(P<0. 025),but that of stomatitis was higher in the ELF than in the FAM (P<0. 001). These results showed that the ELF is a more suitable regimen for pa tients with advanced gastric carcinoma who cannot accept intensive chemotherapy because of having a heart disease or a poor performence status.