奥沙利铂联合5-氟尿嘧啶、亚叶酸钙治疗化疗失败的晚期胃癌的临床观察

Clinical observation of oxaliplatin plus 5-fluorouracil and leucovorin in treatment of advanced gastric cancer patients who failed to respond previous chemotherapy

目的观察奥沙利铂联合5-氟尿嘧啶、亚叶酸钙治疗化疗失败的晚期胃癌患者的临床疗效及不良反应。方法36例患者均经组织病理学证实及有可评价病灶。采用奥沙利铂130mg/m^2,亚叶酸钙(LV)200mg/m^2及5-氟脲嘧啶(5-Fu)500mg/m^2～5方案化疗。3周为1周期,2周期评价疗效。结果36例患者均至少完成2周期化疗,均可评价疗效和不良反应。全组CR患者3例(8.3%),PR11例(30.6%),SD12例(33.3%),PD10例(27.8%)。有效率为38.9%。主要不良反应为血液系统毒性、粘膜炎与感觉神经毒性。结论奥沙利铂联合5-氟脲嘧啶、亚叶酸钙治疗化疗失败的晚期胃癌患者有一定的客观缓解率,不良反应可以耐受,值得进一步研究。

Objective To investigate the efficacy and toxicity profile of oxaliplatin plus 5 - fluorouracil,leucovorin in treatment of advanced gastric cancer patients who failed to respond previous chemotherapy. Methods From Jun 2004 to Dec 2005, 36 patients with pathologically proven of advanced gastric cancer patients who failed to respond previous chemotherapy were analyzed retrospectively. All patients were treated with Oxaliplatin 130mg/m^2 on the first day,and 5-fluorouracil 500mg/m^2＋Leucovorin 200mg/m^2- 5 repeated every 3 weeks, and the clinical responses were assessed after two cycles.Results All patients were treated at least 2 cycles chemotherapy.The objective response rate was CR3（8.3%）, PR11（30.6%）,SD12（33.3%）, and PD10（27.8%） respectively. The overall response rate was 38.9%.The main side effects were hematological toxicity,mucositis and sensory neuritis. Conclusion The combination of oxaliplatin,5-fluorouracil and leucovorin is a moderatedly active treatment with tolerable side effects for advanced gastric cancer patients who failed to respond previous chemotherapy.Its treatment value is worth further studying.