FOLFOX方案与EPLF方案治疗晚期胃癌疗效比较

FOLFOX versus EPLF regimens in treatment of advanced gastric carcinoma

目的观察FOLFOX方案(草酸铂、四氢叶酸钙和5-Fu)与EPLF方案(表阿霉素、顺铂、四氢叶酸钙和5-Fu)治疗晚期胃癌的近期疗效和毒副作用。方法54例Ⅲb和Ⅳ期胃癌患者依入院次序分组,接受FOLFOX方案与EPLF方案治疗两周期后评价疗效。结果FOLFOX方案组有效率51.9%(14/27),EPLF方案组有效率44.4%(12/27),但两组差异无显著性(P>0.05);FOLFOX组Ⅲ+Ⅳ度白细胞减少(6/27)与FOLFOX组(0/27)相比差异有显著性(χ2=6.087,P=0.0166)。FOLFOX方案组周围感觉神经炎的发生率较EPLF方案组高,恶心、呕吐、脱发的发生率较FOLFOX低,两组差异有显著性(P<0.05)。结论两种方案疗效肯定,均可作为胃癌化疗的临床一线方案应用,对一些年老体弱或多次化疗后骨髓耐受差的患者可能更适合FOLFOX方案。而在临床方案选择时,提示可根据不同的患者的实际情况选择。

Objective To compare the curative effect and the side effects of the regimen FOLFOX [ leucovorin （ LV ） , 5-fluorouracil （5-Fu） and oxaliplatin （L-OHP） ] with the regimen EPLF （ epirubicin, cisplatin,leucovorin and 5-Fu）. Methods A total of 54 patients with advanced gastric carcinoma entered this trial. They were randomly and equally divided into FOLFOX group and EPLF group. Every course lasted 4 weeks and the cases were evaluated after at least 2 courses. Results The response rate was 51.9% （14/27） in FOLFOX group and 44.4 % （ 12/27 ） in EPLF group, with no statistical difference （ P 〉 0.05 ）. The main side effects were grade-3 and -4 leukopenia and sensory neuritis in FOLFOX group and nausea,vomiting and alopecia in EPLF group, with significant statistical difference between the two groups （ P 〈 0.05 ）. Conclusion This study suggests that the regimen FOLFOX and regimen EPLF are effective as first-line treatment of advanced gastric carcinoma. FOLFOX regimen is more suitable for the patients who are old and weak or have leucopenia after chemotherapy.