FOLFOX4方案和ECF方案治疗晚期胃癌的比较

Comparison of FOLFOX4 regimer and ECF regimen on advanced gastric carcinoma

目的：比较FOLFOX4方案和ECF方案治疗晚期胃癌的临床疗效及不良反应。方法：将50例经病理确诊的晚期胃癌患者随机分为两组。治疗组25例，采用FOLFOX4方案化疗：草酸铂85mg／m^2，静脉滴注2h，d1；亚叶酸钙200mg／m^2，静脉滴注2h，d1、d2；氟尿嘧啶400mg／m^2，静脉推注，d1、d2，氟尿嘧啶600mg／m^2，持续静脉泵输注22h，d1、d2。每2周为1周期。对照组25例，采用ECF方案化疗：表柔比星50mg／m^2，静脉推注，d1；氟尿嘧啶400mg／m^2，静脉滴注，d1～d5；顺铂20mg／m^2，静脉滴注，d1～d3。每3周为1周期。对两组的缓解率、生活质量改善率、不良反应进行分析比较。结果：治疗组与对照组的缓解率分别为56％（14／25）和52％（13／25），无显著性差异（χ^2=0．73，P〉0．05）；生活质量改善率分别为76％（19／25）和48％（12／25），有显著性差异（χ^2=6．23，P〈0．05）；两组主要不良反应白细胞减少、腹泻、口腔炎、神经毒性和脱发等指标的差异具有显著性（P〈0．05）。结论：FOLFOX4方案和ECF方案治疗晚期胃癌近期疗效较好，不良反应较轻；在生活质量改善方面，FOLFOX4方案优于ECF方案。

Objective：To compare the efficacy and toxicity of FOLFOX4 regimen and ECF regimen in the treatment on patients with advanced gastric carcinoma（AGG）. Methods：Fifty patients with AGG were divided into two groups randomly. FOLFOX4 regimen： L-OHP （85mg,/m2 iv2h dl） were given first, CF （200mg/m2 iv2h dl, d2） followed by 5-FU （400mg,/m2 iv d1 , d2） and5- FU （600mg,/m2 civ 22h dl, d2） were given. FOLFOX4 regimen was repearted every 14 days. ECF regimen： EPI （50mg,/m2 iv d1 ）, 5-FU （400mg,/m2 iv d1 -d5 ） and DDP （20mg/m2iv d1-d3 ） were given. ECF regimen was repeated every 21 days. The overall rate of response, improvement of QOL and toxicity for the two regimens were analysed. Results：The response rate （RR） of FOLFOX4 and ECF were 56% （14/25） and 52% （13/25）, respectively. There was no significant difference （χ^2 =0. 73 ,P 〉0.05 ）. The improvement of QOL of FOLFOX4 and ECF were 76% （19/25） and 48% （12/25）, respectively. There was significant difference （χ^2= 6. 23, P 〈 0.05 ）. The major side effect of the two groups had significant difference. Conclusion： FOLFOX4 regimen and ECF regimen show good efficacy in AGG. The toxicity is mild and tolerable. On the improvement of QOL, FOLFOX4 regimen is better than ECF regimen.