TOFU/LV时辰化疗方案治疗进展期胃癌的临床研究

Clinical study on TOFU/LV chronochemotherapy in advanced gastric cancer

目的:观察和评价应用TOFU/LV时辰化疗方案治疗进展期胃癌的疗效及不良反应。方法:奥沙利铂(LOH-P)125mg/m2d1上午10时至下午4时静脉滴注,吡喃阿霉素(THP)35mg/m2d1上午10时后静冲,亚叶酸钙(CF)200mgd2-6在应用5-FU前静脉滴注。氟尿嘧啶(5-FU)400mg/m2d2-6晚10时至次日上午10时静脉滴注,并于氟尿嘧啶静滴前静注250mg/m2,21天为1周期,2个周期为1疗程,至少完成2个周期后评价疗效。结果:入组12例均可评价疗效,有效率(CR+PR)58.3%(7/12)SD25%(3/12),PD16.7%(2/12)。中位生存期(MST)10.5个月,中位疾病进展时间(TTP)5.2个月。主要不良反应为外周神经毒性,消化道反应,骨髓抑制。结论:应用TOFU/LV时辰化疗方案治疗进展期胃癌,可提高进展期胃癌的临床缓解率?延长生存期,改善病人的生活质量,且不良反应较常规化疗减轻。

Objective：To observe and evaluate the curative effect and side effect of TOFU/LV chronochemotherapy schedule in patients with advanced gastric cancer. Methods： Oxaliplatin （LOH- P） 125mg/m^2 d1 was adminitstered by intervenous drop infusion from 10 AM to 4PM. Perarubicin（THP） 35mg/m2 d1 was given after 10AM by intervenous drop infusion. Calcium folinate（CF） 200rag d2-6 was dripped before 5 - FU was used. 5 - FU 250mg/m^2 d2-6 was intravenous injected first,then 400mg/m2 d2-6 was used by intervenous drop infusion from 10 PM to 10 AM. The regimen was repeated every 21 days ,2 cycles was one course. Curative effects were evaluated after at least 2 courses. Results： The overall response rate was 58.3 % （ 7/12, CR ＋ PR）, SD 25 % （ 3/12 ） and PD 16.7 % （2/12）. The midian life span time（MST） was 10.5 months,the midian time to progression （3TP） was 5.2 months. Major side effects were peripheral nerve toxicity, gastrointestinal adverse and bone marrow myelosuppression. Concusion：TOFU/ LV chronochemotherapy schedule increased clinical response rate, prolonged life span, improved quality of life, and reduced adverse effects compared with routine chemotherapy regimen in advanced gastric cancer.