FOLFOX4方案治疗晚期胃癌的疗效观察

The curative effect of FOLFOX4 regimen in the treatment of advanced gastric cancer

目的:观察FOLFOX4方案治疗晚期胃癌的临床疗效和不良反应。方法:32例晚期胃癌患者接受FOLFOX4方案化疗,即:奥沙利铂(L-OHP)85mg/m2,静脉滴注2h,d1;亚叶酸钙(CF)200mg/m2,静脉滴注2h,d1、d2;氟尿嘧啶(5-Fu)400mg/m2,静脉推注,d1、d2,600mg/m2,持续静脉滴注22h,d1、d2。每2周重复。治疗4周-6周期后按WHO实体瘤疗效评定标准评价疗效及毒副反应。结果:全组32例均可评价疗效,总有效率50.0%(16/32)。其中,初治15例,CR2例,PR6例,有效率53.3%;复治17例,无CR,PR8例,有效率47.1%;初治与复治的疗效之间有统计学差异(P<0.05)。16例获缓解者的中位缓解期为7.4个月,中位生存期10.5个月。不良反应主要为神经毒性,包括四肢感觉异常、冷刺激敏感、握力下降等,多数患者耐受良好,其次是恶心、呕吐、腹泻、血细胞下降等,无因毒副反应而终止治疗者,无治疗相关性死亡。结论:FOLFOX4方案治疗晚期胃癌近期疗效好,不良反应较轻,多数患者耐受,是治疗晚期胃癌的较好方案。

Objective：To observe the efficacy and side reaction of FOLFOX4 regimen for patients with advanced gastric cancer. Methods：Total of 32 patients with advanced gastric cancer, with 20 men, 12 women were enrolled in the study. FOLFOX4 regimen：OXA 85mg/m^2 iv 2h d1 ,LV 200mg/m^2 iv 2h followed by 5 - FU 400mg/m^2 iv bolus and 5 - FU 600mg/m^2 iv 22h d1 - d2, repeated every 2 weeks. Efficacy and side - effects were evaluated after 4 - 6 cycles. Results： All 32 patients have been entered into the study. ORR 50%. Two of naive patients achieved CR （ 13.3 % ）, 14 PR （43.8%）, Secondary remedy patients achieved 0 CR, 8 PR. Overall response rate （ORR） for chemotherapy naive（ 1^st line） and pretreated （2^nd line） patients were 53.3% （ 8/15 ） and 47.1% （ 8/17 ）, respectively. The two groups had significant difference. Median time to progress（mTTP）was 7.4 months. The main toxicities were toxicity of nausea/vomiting,myelosuppression,neutropenia and thrombocytopenia. There were no deaths during treatment. Conclusion：FOLFOX4 is a high response regimen for advanced gastric cancer with mild toxicity.