FOLFOX4方案治疗晚期胃肠道恶性肿瘤的临床研究

Clinical study on FOLFOX4 in the treatment of advanced gastro-colorectal cancer

目的评价国产奥沙利铂(L-OHP)联合亚叶酸钙(LV)和5-氟尿嘧啶(5-Fu)2周方案(FOL-FOX4),治疗晚期胃肠道恶性肿瘤的近期疗效和毒副反应。方法均给予FOLFOX4方案治疗,即L-OHP 80-100mg/m2,静脉滴注3-4小时,d1;LV200mg/m2,静脉滴注2小时后立即静脉推注5-Fu 400mg/m2,后续5-Fu600mg/m2持续静脉滴注22小时,d1-2。每2周重复,3-4周期后评价疗效。结果晚期胃癌40例中,CR 3例,PR 17例,有效率50.0%(20/40);晚期结直肠癌46例中,CR 5例,PR15例,有效率为43.5%(20/46)。两者经统计学处理,无显著性差异(P>0.05)。胃癌初治有效率为64.0%(16/25),复治有效率为26.7%(4/15);大肠癌初治有效率为63.6%(14/22),复治有效率25.0%(6/24);初治与复治两者经统计学处理有显著性差异(P<0.05)。毒副反应主要为感觉神经毒性、恶心呕吐和白细胞下降。结论国产奥沙利铂联合LV和5-Fu组成的FOLFOX4化疗方案治疗晚期胃肠道恶性肿瘤疗效较好,毒副反应轻,且价格适中。

Objective To evaluate the effects and toxicity of FOLFOX4 regimen in chemotherapy for patients with advanced gastro - colorectal cancer. Methods Eighty - six patients with advanced gastro - colorectal caricer were received L - OHP 80 - 100 mg/m^2 infusion for 3 -4 hours on the first day; LV 200 mg/m^2 infusion for 2 hours followed by 5 - Fu 400mg/m^2 bolus injection, and then 5 - Fu 600mg/m^2 infusion for 22 hours from first day to second day. All patients received this treatment for 3 - 4 times （ two weeks per cycle）. Results The response rate （RR） were 50.0% （20/40） for stomach cancer （CR： 3 cases, PR： 17 cases）, 43.3% （20/46） for colorectal cancer （CR： 3 cases, PR： 16 cases）. There was no significant difference in two groups （ P 〉0.05）. The response rate for chemotherapy initial treatment and retreatment were 64.0% （16/25） and 26.7% （4/15） for advanced gastric cancer, respectively. And it was 63.6% （14/22） and 25.0% （6/24） for advanced colorectal cancer, respectively. There is significant difference in two groups （ P 〉 0.05 ）. The main toxicity was neuro - sensory （63.9%）, vomiting （40.7%） and leucopenia （56.9%）. Conclusion Oxaliplatin combined with LV/5 - Fu dropping of vein lasting chemotherapy regimen is high response and well tolerable for advanced gastro -colorectal cancer.