草酸铂联合亚叶酸钙和5-氟尿嘧啶治疗晚期胃癌的临床观察

Clinical observation of Oxaliplatin incombination with LV5FU2 for advanced gastric cancer

目的观察草酸铂联合亚叶酸钙,5-氟尿嘧啶(OXA-LV5FU2)方案治疗晚期胃癌的疗效及安全性。方法草酸铂(L-OHP)100mg/m2,静脉滴注3h,第一天;亚叶酸钙(LV)200mg/m2,静脉滴注2h后推注5-氟尿嘧啶(5-Fu)400mg/m2,后续5-Fu600mg/m2,静脉持续输注24h,第1,2天。每2周重复,行4周期(8周)治疗后判定疗效。结果入组观察30例,其中行原发灶切除者11例,未切除者19例。可评价疗效者29例,其中完全有效(CR)3例(10.3%),部分有效(PR)12例(41.4%),稳定(SD)11例(38.0%),进展(PD)3例(10.3%)。总有效率(ORR)51.7%(15/29),初治(一线)ORR66.7%(12/18),复治(二线以上)ORR27.3%(3/11),中位无进展期(mTTP)4.8个月,中位总生存期(mOS)7.8个月。30例中不良反应为3度者9例,其中白细胞减少4例(13.3%),恶心、呕吐3例(10.0%),外周神经感觉异常及转氨酶升高各1例(3.3%)。无化疗相关死亡。结论OXA-LV5FU2方案治疗晚期胃癌疗效良好,不良反应轻而且安全。

Objective The study was designed to evaluate the effects and safety of OXA-LVSFU2 regimen for patients with advanced gastric cancer. Methods OXA100mg/m^2 iv gtt 3 hr dl,LV200 mg/m^2 iv gtt 2 hr followed by 5-Fu 400 mg/m^2 iv bolus and 5-Fu 600 mg/m^2 iv 22 hr dl,2 were given,and repeated every 2 wceks.Effiecy was evaluated at 4 cycles （8 weeks）. Results 30 patients have been entered into the study. Patients with primary tumor resected or non-reseeted were 11 and 19. 29 patients were evaluable for clinical response. 3 patients achieved complete response （10.3%）,12 partial response （41.4%）,11 stable disease （38.0%）and 3 progressive disease （10.3%）.Overall responserate（ORR）for chemotherapy were 51.7%（15/29）, ORR in halve（1^st line） and pretreated （2^nt line）patients were 66.7%（12/18）and 27.3%（3/ll）,respectively.Median time to progress （mTTP） was 4.8 months and median overall survial （mOS）was 7.Smonths.30 patients were evaluabh for toxicity, with Grade3-4 WHO toxicity of neutropeniain 4 patients （13.3%）, nausea/vomiting 3 patient （10.0%）.Peripheral neurotoxity 1 patient （3.3%）and ALT/AST increase 1 patient （3.3%）. There were no any deaths during treatmerit. Conclusions OXA2LV5FU2 is a high response and safe regimen for advanced gastric cancer without severe toxicity. Which can be practiced safely.