FOLFOX4方案和ECF方案治疗老年晚期胃癌的疗效比较

Comparison of FOLFOX4 regimen and ECF regimen on advanced gastric carcinoma in elderly patients

目的:比较FOLFOX4方案和ECF方案治疗老年晚期胃癌的疗效及不良反应。方法:将56例经病理确诊的老年晚期胃癌患者随机分为两组。A组29例,采用FOLFOX4方案化疗:草酸铂75mg/m2,静脉滴注2h,d1;亚叶酸钙200mg/m2,静脉滴注2h,d1-2;氟尿嘧啶400mg/m2,静脉推注,d1、d2,氟尿嘧啶600mg/m2,持续静脉泵输注22h,d1-2。每2周为1周期。B组27例,采用ECF方案化疗:表柔比星45mg/m2,静脉推注,d1;氟尿嘧啶675mg/m2,持续静脉泵输注120h;顺铂20mg/m2,静脉滴注,d1-3。每3周为1周期。对两组的近期疗效、疾病进展时间、总生存期、生活质量改善情况、不良反应进行比较。结果:A组和B组的有效率分别为41.4%(12/29)和44.4%(12/27),无显著性差异(P=0.8168)。A组和B组的中位疾病进展时间4.6月(1-15月),4.8个月(1-14月)(P=0.8899);中位生存时间7月(2-16月),6.9月(2-16月)(P=0.2905)。A组和B组的生活质量改善为65.5%(19/29)和37.0%(10/27)有显著性差异(P=0.0331);两组主要不良反应白细胞减少、腹泻、口腔炎、神经毒性、脱发、心脏毒性等指标的差异具有显著性(P<0.05)。结论:FOLFOX4方案和ECF方案治疗老年晚期胃癌近期疗效较好,在生活质量改善以及不良反应方面,FOL-FOX4方案优于ECF方案,具有更好的耐受性。

Objective：To compare the efficacy and toxicity of FOLFOX4 regimen and ECF regimen on advanced gastric carcinoma（AGG） in elderly patients.Methods：Fifty six patients with AGG were divided into two groups randomly,29 patients in group A treated with FOLFOX4 regimen：L-OHP（75mg/m^2 iv 2h d1） were given first,CF（200mg/m^2 iv 2h d1-2） followed by 5-FU（400mg/m^2 iv d1-2） and 5-FU（600mg/m^2 civ 22h d1-2） were given,repeated every 14 days;27 patients in group B treated with ECF regimen：EPI（45mg/m^2 iv d1）,5-FU（675mg/m^2 civ 120h） and DDP（20mg/m^2 iv d1-3） were given,repeated every 21 days.The efficacy,time to disease progression（TTP）,overall survival（OS）,improvement of QOL and toxicity of the two regimens were analyzed.Results：The response rate（RR） of group A and B were 41.4%（12/29）and 44.4%（12/27）,respectively.There was no significant deference（P=0.8168）.The median TTP was 4.6months in group A and 4.8 months in group B（P=0.8899）.The median survival time was 7 months in group A and 6.9 months in group B（P=0.2905）.The improvement of QOL of A and B were 65.5%（19/29） and 37%（10/27）,respectively,（P=0.0331）.Major side effect of the two groups had significant deference（P〈0.05）.Conclusion：Both FOLFOX4 and ECF regimens were effective in treating advanced gastric cancer in elderly patients.FOLFOX4 regimen is better than ECF regimen on the improvement of QOL and toxicities survivability.