顺铂和5-Fu腹腔化疗联合FOLFOX4方案静脉化疗治疗晚期胃癌疗效观察

The Observation of Intraperitoneal Chemotherapy of 5-Flurouracil and Cisplatin Combined with Intravenous Chemotherapy of FOLFOX4 Regimen for Patients with Advanced Gastric Cancer

目的观察腹腔化疗联合静脉化疗治疗晚期胃癌的临床疗效及毒副反应。方法39例晚期胃癌患者接受腹腔及静脉化疗,先予5-Fu+DDP腹腔灌注化疗,继予FOLFOX4方案静脉化疗,14 d为1周期,完成4周期后评价疗效。结果39例均可评价疗效。可测量病灶:CR 3例(7.7%),PR 17例(43.6%),NC 11例(28.2%),PD 8例(20.5%),客观有效率(CR+PR)51.3%(20/39)。26例腹水疗效:CR 7例(26.9%),PR 12例(46.2%),NC 4例(15.4%),PD 3例(11.5%),有效率(CR+PR)73.1%(19/26)。中位疾病进展时间6.1个月,中位生存期8.3个月,1年生存率35.9%。39例Ⅲ/Ⅳ度毒副反应中白细胞减少4例(10.3%),恶心、呕吐2例(5.1%),口腔黏膜炎1例(2.6%)。无治疗相关性死亡。结论腹腔化疗联合静脉化疗是治疗晚期胃癌的有效手段,毒副反应可以耐受。

Objective To observe the therapeutic efficacy and side effects of intraperitoneal chemotherapy combined with intravenous chemotherapy. Methods 39 patients with advanced gastric cancer were treated with intraperitoneal chemotherapy combined with intravenous chemotherapy. They received an intraperitoneal chemotherapy of 5-flurouracil and cisplatin, followed an invenous chemotheraphy of FOLFOX4 regimen, and 14 days as a cycle. Efficacy was evaluated after 4 cycles. Results 39 patients were evaluated for clinical response and toxicity. The response rate was 51.3% （20/39） , CR 3 cases（7.7% ） , PR 17 cases（43.6% ） , NC 11 cases（28.2% ） , PD 8 cases（20.5% ）. The response rate for malignant abdominal effusion in 26 patients was 73.1% （19/26） , CR 7 cases（26.9% ） , PR 12 cases（46.2% ） , NC 4 cases（ 15.4% ）, PD 3 cases（ 1 1.5% ）. Median time to progression was 6.1 months, and 1-year survival rate was 35.9% with a median survival time of 8.3 months. There were grade Ⅲ/Ⅳ WHO toxicity of leukopenia in 4 patients（ 10.3% ） , nausea/vomiting in 2 patients （5.1% ）, stomatitis in 1 patients（2.6% ）. There was no corresponding death during treatment. Conclusions The treatment of intraperitoneal chemotherapy combined with intravenous chemotherapy is effective and tolerable for patients with advanced gastric cancer.