FOLFOX4方案治疗晚期胃癌的临床研究

THE CLINICAL OBSERVATION OF FOLFOX4 REGIMEN FOR ADVANCED GASTRIC CANCER

[目的]研究FOLFOX4方案治疗晚期胃癌的疗效和毒副反应。[方法]观察82例晚期胃癌患者。41例治疗组患者予以FOLFOX4方案治疗:奥沙利铂85mg/(m·2d),静脉滴注2h,d1;亚叶酸钙200mg/(m2·d)静脉滴注2h,d1、2;5-FU 400mg/(m2·d),于亚叶酸钙滴完后快速滴注,d1、2;5-FU 600mg/(m·2d),持续泵入24h,d1、2。每2周重复,4周为1个周期。至少连用2个周期后疗效评定。41例对照组患者方案为:亚叶酸钙200mg/(m·2d)静脉滴注2h,d1～5;5-FU 0.75mg/(m·2d),于亚叶酸钙滴完后滴注,d1～5。[结果]治疗组完全缓解率(CR)为7.3%,部分缓解率(PR)为46.3%,总有效率(CR+PR)为53.6%;对照组完全缓解率(CR)为2.4%,部分缓解率(PR)为22%,总有效率(CR+PR)为24.4%。毒副反应主要为神经毒性、骨髓抑制和消化道反应。[结论]FOL-FOX4方案治疗晚期胃癌的疗效优于5-FU+亚叶酸钙方案,毒副反应患者可以耐受。

[Objective] To study the response and toxicities of FOLFOX4 regimen for advanced gastric cancer. [Methods] 82 patients with advanced gastric cancer were divided into two groups.Treatment group （41 cases） received FOLFOX4 regimen： Oxaliplatin 85 mg/m^2 Ⅳ over 2 hours, day 1; Leucovorin 200 mg/m^2 IV over 2 hours, days 1 and 2; 5-FU 400 mg/m^2 Ⅳ bolus, then 600 mg/m^2 Ⅳ over 22 hours continuous infusion, days 1 and 2, which repeated every 2 weeks. Control group （41 cases） ： Leucovorin 200 mg/m^2 Ⅳ over 2 hours, days 1 to 5, 5-FU 750 mg/m^2 Ⅳ, days 1 to 5, which repeated every 3 weeks. [Results] The complete response rates in the treatment group and control group were7.3% and 2.4%, partial response rates were 46.3% and 22 %, and the overall response rate was 53.6% and 24.4% respectively. The major toxic effects were neurotoxicity, gastrointerstinal tract reactions and myelosuppression. [Conclusion] Compare with Leucovorin and 5-FU, the FOLFOX4 regimen for advanced gastric cancer have a good response and tolerable toxicity.