奥沙利铂联合5-氟尿嘧啶和亚叶酸钙时辰治疗胃肠肿瘤的临床观察

Chronomodulated chemotherapy of oxaliplatin, 5 - fluorouracil and Calcium folinate for gastric and colon cancer

目的观察奥沙利铂L—OHP联合5一氟尿嘧啶5-fu、亚叶酸钙CF方案LPF时辰输注法治疗胃肠肿瘤的疗效和毒副反应。方法LPF方案时辰输注33例胃肠肿瘤患者，L-OHP（30mg/m^2）、5-fu（400mg／m^2）、CF（100mg／m^2），多通道程控时辰输液泵连续给药4天，每21天为一个周期，至少3个周期。结果33例胃肠肿瘤患者中，可评价疗效的22例晚期患者，完全缓解2例。部分缓解10例，稳定4例，进展3例，总有效率54．6％，平均肿瘤进展时间4．5月，平均生存时间8月。在总共123个周期化疗中，最常见的不良反应为血液学毒性、胃肠道毒性、外周神经毒性、均以Ⅰ度为主，Ⅲ度中性粒细胞减少2例，血小板减少1例，未出现IV度不良反应。结论LPF方案时辰输注治疗胃肠肿瘤是有效的化疗方法，且较常规用药方法毒副反应轻，提高了生活质量。

Objective The combination of oxaliplatin（L-OHP）, 5-fluorouracil（5-Fu） and folinlc acid（CF） is used in form of chronomodulated chemotherapy for gastric and colon cancer to investigate its efficacy and safety. Methods Thirty-three patients received a 4-day chronomodulated infusion of L-OHP, 5-Fu and CF. L-OHP （30mg/m^2/d） infused from 10：00 am to 22：00pm, and followed by 5-fu （400mg/m^2/d） and CF （100mg/m^2/d） from 22：00 pm to 10：00 am for 4 days using a multichannel programmable pump, every twenty-one days as a cycle for at least 3 cycles. Result Among the thirty-three patients, twenty-two patients with previously untreated advanced gastric and colon cancer were eligible. Two complete and 10 partial remissons were observed with an overall response rate of 54.6% stable disease was observed in 4 patientes and progressive disease in 3 patientes. Time to tumer progression （TTP） was 4.5months and the median overall survival time was 8 months. A total of 123 cycles were given without any grade 4 toxicity observed and two grade 3 neutropenia in 2. Conclusion chronomodulated chemotherapy of oxaliplatin, 5-fluorouracil and folinic acid is more effective and safe in the treatment of gastric and colon cancer.