羟基喜树碱联合FOLFOX4方案二线治疗晚期胃癌

Clinical analysis of HCPT plus FOLFOX4 regimen as salvage therapy for patients with advanced gastric cancer

目的:评价羟基喜树碱(HCPT)联合FOLFOX4方案作为二线治疗晚期胃癌的疗效和毒性。方法:19例晚期胃癌患者,先给予奥沙利铂(L-OHP)85mg/m2静脉滴注2h,第1天;亚叶酸钙(CF)200mg/m2静脉滴注2h;随后5-FU400mg/m2静脉快速冲入,5-FU600mg/m2静脉滴注22h,第1～2天;HCPT10mg静脉滴注3h,第1～2天。2周重复,至少2个周期后评价疗效。结果:全组19例患者,17例可以进行疗效评价,完全缓解1例,部分缓解6例,稳定4例,进展6例,总有效率为41.2%。12例存在肝脏转移患者中,肝转移灶有效率50%。毒副作用主要是骨髓抑制、恶心呕吐、神经毒性,无化疗相关死亡。结论:羟基喜树碱联合FOLFOX4方案二线治疗晚期胃癌疗效肯定,特别是对于肝转移灶有效率高,毒副作用能够耐受。

Objective：To evaluate the efficacy as well as side effects of HCPT plus FOLFOX4 regimen as salvage therapy for patients with advanced gastric cancer.Methods：A total of 19 patients with advanced gastric cancer received HCPT plus FOLFOX4 as salvage therapy,in detail,oxaliplatin 85mg/m^2 was given intravenously on day 1,CF 200mg/m^2,5-FU 400mg/m^2 given in bolus immediately after CF,days 1-2;5-FU 600mg/m^2 given continuously after bolus for 22 hours on days 1-2.HCPT given intravenously at dosage of 10mg/m^2,on days 1-2.Therapeutic effects were evaluated at least after two cycles of treatment.Results：Seventeen cases among the 19 cases were valid for response evaluation,with CR 1,PR 6,SD 4,PD 6.The response rate was 41.2%.For the 12 patients with liver metastasis,response rate of the liver foci was 50%.The main toxicities were bone marrow suppression,nausea and vomiting,neurological toxicity;there was no chemotherapy-related death.Conclusion：The combination regimen with HCPT plus FOFLOX4 regimen is effective as salvage therapy for patients with advanced gastric cancer,especially for liver metastatic foci,and the side effects were tolerable and manageable.