替加氟和氟尿嘧啶分别与草酸铂联合持续静脉滴入治疗晚期胃癌的比较研究

Comparative study of continuous intravenous infusional tegafur or 5-fluorouracil combined with oxaliplatin in the treatment of advanced gastric cancer

目的：探讨持续静脉滴入替加氟、氟尿嘧（5-FU）分别与草酸铂（L-OHP）联合对晚期胃癌的效果。方法：67例晚期胃癌患者分别接受方案A（32例）和方案B（35例）治疗。方案A：替加氟800mg／m^2，持续静脉滴入（24h），d1～d5；甲酰四氢叶酸（LV）200mg／m^2，静脉滴入（2h），d1～d5；L-OHP135mg／m^2，静脉滴入（2h），d1。方案B：5-FU750mg／m^2，持续静脉滴入（24h），d1～d5；LV与L—OHP应用方法同方案A。均21d为1个周期。结果：67例患者中CR9例，PR34例，有效率64．0％。TTP和MST分别为7．2个月和11．3个月。方案A有效率高于方案B，分别为68．8％和60．0％，但差异无统计学意义（Χ^2=0．557，P=0．456）。初次化疗患者有效率高于既往接受化疗者，分别为73．7％和60．4％。对复治患者方案A有效率为69．6％，方案B为52．0％，尽管方案A组有效率呈现增高的趋势，但差异无统计学意义（Χ^2=1．545，P=0．214）。两种治疗方案的不良反应均易于耐受。结论：持续静脉滴入替加氟、氟尿嘧啶分别与草酸铂联合可以作为晚期胃癌安全有效的治疗方案。

OBJECTIVE： To study the effects of continuous intravenous infusional （CIV） tegafur or 5-fluorouracil （5- FU） combined with oxaliplatin in the treatment of advanced gastric cancer. METHODS： Sisty-seven advanced gastric cancer patients were treated with regimen A or regimen B. Regimen A： tegafur 800 mg/m^2, CIV （24 h）,d1-d5 ; LV 200 mg/m^2, iv（2 h）,d1-d5; L-OHP 135 mg/m^2, iv（2 h）,d1. Regimen B： 5-FU 750 mg/m^2,CIV （24 h）,d1-d5; the suage of LV and Loup is sawe as the regimen A. Regimen A and B were repeated every 21 days. RESULTS： There were 9 CR, 34 PR cases in the 67 patients. Response rate （RR） was 64.0%. TTP and MST were 7.2 months and 11.3 months respectively. The RRs of regimen A and B were 68.8% and 60.0% respectively. The difference did not reach the level of statistical significance （Χ^2 =0. 557,P=0. 456）. The RRs of naive-chemotherapy and pre-chemotherapy patients were 73.7% and 60.4% respectively. For pre-chemotherapy patients, the RRs of regimen A and regimen B were 69.6% and 60.4% respectively. The difference did not reach the level of statistical significance （Χ^2=1. 545, P=0. 214）. The adverse effects of the two regimens were mild. CONCLUSIONS： The ragiment of continuous intravenous infusional （CIV） tegafur or 5 fluorouracil （5-FU） combined with oxaliplatin for advanced gastric cancer is safe and effective.