FOLFOX_4方案治疗晚期胃癌的临床疗效

Curative effects of the FOLFOX_4 regimen in the treatment of adavanced gastric cancer

目的:观察FOLFOX_4对晚期胃癌的近期疗效和不良反应。方法:给予124例晚期胃癌患者奥沙利铂100mg/m^2静脉滴注第一天;亚叶酸钙200mg/m^2静脉滴注2小时第1、2天;5-氟尿嘧啶400mg/m^2,快速静脉滴注第1、2天;5-FU 600mg/m^2持续静脉滴注22小时,第1、2天,每14天为一个周期,至少完成4个周期者评价疗效和不良反应。结果:可评价病例124例,共计546个周期,平均4.4周期,完全缓解(CR)12/124(9.7%),部分缓解(PR)52/124(41.9%),总缓解率64/124(51.6%),稳定(SD)37/124(29.8%),进展(PD)23/124(18.5%)。不良反应为:神经毒性62/124(50%),中性粒细胞减少40/124(32.2%),血小板减少16/124(12.9%),恶心、呕吐37/124(29.8%)。不良反应主要为神经毒性及血液毒性,消化道反应轻。结论:此方案治疗晚期胃癌疗效肯定,不良反应可以耐受。

Objective：To observe the curative effects and adverse reactions of the FOLFOX4 regimen（oxaliplatin combined with fluorouracil and calcium folinate ） in the treatment of adavanced/metastatatic gastric cancer. Motheds ： Total of 124 patients with advanced gastric cancer were treated by FOLFOX4 regimen： oxaliplatin 150 mg/ m^2, ivgtt, d1 ; calcium folinate 200 mg/m^2, ivgtt, 2 hours, d1-2 ; followed by 5 - FU 400mg/m^2, iv, d1-2 and 600mg/m^2 ,22 hours, eiv, d1-2, two weeks were a cycle. Efficacy was evaluated after 4 cycles. Results： In all 124 patients evaluated,total 546 cycles were given,average 4.4 cycles,complete response（CR） 12/124（9.7% ）, partial response （PR） 52/124（41.9% ） ,stable disease （SD） 37/124（29.8% ） ,progression disease （PD） 23/124（18.5% ）, overall response rate 64/124（51.6% ）. The major toxicity was neurotoxicity and hematotoxicity,less gastrointestinal side effects; Ⅲ - Ⅳ adverse reactions included： neurotoxicity 62/124 （50%）, neutropenia 40/124 （ 32.2% ）, thrombocytopenia 16/124 （ 12.9% ）, nausea ＆ vomiting 37/124 （ 29.8% ）. Conclusion： The regimen of FOLFOX4 is effective and tolerable in advanced gastric cancer.