改良的FOLFOX4方案治疗晚期胃肠癌的临床观察

A Clinical Study of Metastatic Gastrointestinal Cancer with Modified FOLFOX4 Regimen

目的观察改良的FOLFOX4方案治疗晚期胃肠癌的临床疗效和耐受性。方法36例晚期胃肠癌接受FOLFOX4方案化疗:奥沙利铂85 mg/m2,静脉滴注2 h,d1;甲酰四氢叶酸钙200 mg/m2,静脉滴注2 h,d1,2;氟脲嘧啶400 mg/m2,快速静脉滴注,d1,2,600mg/m2,持续静脉滴注22 h,d1,2,每14 d为1周期(4周期后进行疗效评价)。结果全组36例均可评价疗效,总有效率47.2%(17/36)。初治25例,CR 3例,PR 10例,有效率52%;复治11例,CR 0例,PR 4例,有效率36.4%;初治与复治的疗效之间差异有统计学意义(P<0.05)。中位肿瘤进展时间(TTP)为8.1个月,中位生存期16.2个月。毒副反应主要为胃肠道反应、周围神经毒性及骨髓抑制等。无治疗相关性死亡。结论改良的FOLFOX4方案为治疗晚期胃肠癌的有效方案,毒副反应较轻,患者可耐受。

Objective To study the efficacy and tolorance of oxiplatin（L-OHP） in combination with infusional 5-fluorouracil（5-Fu） and Calcium Folinate（CF） administered every 2 weeks（modified FOLFOX4 regimen） in the treatment of metastatic gastrointestinal cancer.Methods A total of 36 cases with metastatic gastrointestinal cancer received FOLFOX4 regimen： oxaliplatin 85 mg/m2 on day 1,CF 200 mg/m2 as a 2 h infusion followed by bolus 5-Fu 400 mg/m2 and a 22 h infusion of 5-Fu 600 mg/m2,repeated for 2 consecutive days every 2 weeks.Results All the 36 patients were evaluated for efficacy,the overall response rate was 47.2%（17/36）.For 25 patients as first-line chemotherapy,the response rate was 52%（CR 4 patients,PR 10 patients）;for 11 patients as second-line chemotherapy,the response rate was 36.4%（CR 0 patients,PR 4 patients）,the response rate of first-line chemotherapy was significantly better than that of second-line chemotherapy（P〈0.05）. TTP was 8.1 months,PFS was 16.2 months.The adverse reaction mainly including gastrointestinal reaction,peripheral neuropathy and marrow suppression.No death related to this treatment occurred.Conclusion The modified FOLFOX4 regimen is efficient in metastatic gastrointestinal cancer,with good toxicity profile and tolerance.