低剂量长疗程氟尿嘧啶持续滴注治疗老年晚期胃癌

Low dose of fluorouracil continuous infusion for a long time by syringe driver for the elderly with advanced gastric cancer

目的：评价低剂量长疗程氟尿嘧啶（5-Fu）静脉泵持续滴注治疗老年晚期胃癌的客观疗效及毒副反应。方法：117例老年晚期胃癌，采用低剂量5-FU 375mg／d静脉泵持续24小时滴注，连用21天，联用低剂量亚叶酸钙（CF）25mg／m^2、羟基喜树碱（HCPT）10mg和／或顺铂（PDD）10mg，每周各连用5天，共用3周。4周为1个周期，化疗2个周期。结果：117例患者均可评价疗效，获得cR9例（7．7％），PR58例（49．6％），RR67例（57．3％）。毒副反应主要为口腔炎（63．2％）、口腔溃疡（38．5％）、恶心呕吐（36．8％）、腹泻（30．8％）、粒细胞下降（25．6％）、便秘（17．9％）和静脉炎（6．0％），主要为I～Ⅱ级毒副反应，对症处理后均能缓解。结论：低剂量长疗程5-Fu持续滴注治疗老年晚期胃癌患者疗效好，毒副反应不严重，一般均能耐受，值得进一步研究。

Objective：To evaluate the objective anti-tumor efficacy and safety of low dose of fluorouracil（5-FU） continuous infusion for a long time by syringe driver for the elderly with advanced gastric cancer. Methods： One hundred and seveteen cases of elderly advanced gastric cancer were treated with low dose of 5-FU 375mg/day continuous infusion for 24 hours by syringe driver for 21 days with low dose of leucovorin 25mg/m^2 and（or） hydroxy camptothecine 10mg/day and（or） cisplatin lOmg/day for 5 days every week during the 3 weeks. This regimen was repeated every 4 weeks. All the patients received 2 cycles. Results ： All cases could be evaluated. The overall response rate was 57. 3%, including 9 cases complete response （7.7%） and 58 cases partial response （49.6%）. The major toxicity included mucositis, nausea/vomiting, diarrhea and neutropenia phlebitis. Most side effects were grade I～II which were tolerable for the elderly patients. Conclusion： The regimen is an effective chemotherapy for the elderly with advanced gastric cancer. The adverse reactions were not severe. Further clinical study should be warranted.