FOLFOX6方案治疗晚期胃癌41例的临床观察

Clinical study on oxaliplatin combined with 5-fluorouracil and leucovorin in the treatment of advanced gastric cancer

目的本研究观察FOLFOX6方案治疗晚期胃癌的临床疗效及不良反应，以期取得在疗效保证的同时，不良反应小，耐受性更好的效果。方法41例晚期胃癌患者，给予FOLFOX6方案化疗，即：奥沙利铂（L-OHP）100mg／m^2静脉滴注，2h，dl：亚叶酸钙（LV）400mg／m^2，静脉滴注，2h，dl；氟尿嘧啶（5-Fu）400mg／m^2静注推注，dl；后2400mg／m^2微泵持续静脉滴注46h；每2周重复，4周为1周期。均治疗〉2周期，按WHO标准评价客观疗效和不良反应。结果本组41例均可评价疗效，其中完全缓解（CR）3例，部分缓解（PR）16例，稳定（SD）14例，进展（PD）8例，总有效率（CR＋PR）46.34％。中位肿瘤进展时间（TTP）5.4个月，中位生存时间（MST）为9.0个月。不良反应主要是骨髓抑制，胃肠道反应及外周神经毒性。Ⅲ-Ⅳ度白细胞减少和血小板减少的发生率分别为12.20％和4.89％，Ⅲ-Ⅳ度胃肠道反应发生率17.07％，Ⅲ度外周神经病变发生率为2.44％，但患者一般都能耐受。结论FOLFOX6方案治疗国人晚期胃癌的近期疗效较好，不良反应可以耐受，值得进一步研究应用。

Objective The purpose of this study is to evaluate the efficacy and toxicity of oxaliplatin combined with 5-fiuorouracil and leucovorin in the treatment of advaced gasteic cancer and try to find the regimen more tolerable without the deteri-oration of treament respornse. Methods 41 patients with advanced gastric cancer was treated with chemotherapy of regimen ox- aliplatin 100 mg/m^2 d,ivgtt,dl;LV 400 mg/m^2 ivgtt 2h followed by 5-Fu 400mg/m^2（（bolus） and 5-Fu 2400 mg/m^2（46h-coutinous infusion） and repeated every 2 weeks ,4 weeks for one cycle. All patients received two cycles of chemotherapy at least. Efficacy was evaluated after 4 cycles. Results 3 patients achieved complete response （CR）, 16 patients partial response （PR） , 14 patients stable disease（SD） ,8 patients progression disease（PD）. Overall response rate was 46.34%. The median time to progression（mTTP） was 5.4 months. The median su.rvival time（MST） was 9.0 months. The major toxicity included leucopenia,nausea, vomiting and neurosensory. The incidence of grade Ⅲ＋Ⅳ leucopenia 、thrombocytopenia、nausea、 vomiting and sensory neuritis was 12.20% ,4.89% ,17.07% and 2.44%. Conclusion This study shows that the regimen of FOLFOX6 is effective and tolerable in advanced gastric cancer.