阿米福汀联合FOLFOX4化疗治疗晚期胃癌的临床观察

Comparison of FOLFOX4 regimen combined with amifostine with FOLFOX4 regimen for treatment of advanced gastric carcinoma

目的 观察阿米福汀在晚期胃癌联合氟尿嘧啶、亚叶酸钙和奥沙利铂（FOLFOX4）方案化疗中的保护作用.方法 将79例晚期胃癌患者随机分为观察组和对照组,观察组42例患者于化疗前予阿米福汀,同时予FOLFOX4方案化疗;对照组37例予FOLFOX4方案化疗.每4周重复1次,化疗4个周期后评价近期疗效、不良反应、生活质量.结果 观察组有效率42.86%（18/42）,对照组有效率35.14%（13/37）,两组比较差异无统计学意义（P=0.483）;不良反应（包括白细胞降低、尿素氮升高、肌酐升高和末梢神经炎）观察组明显少于对照组（均P〈0.05）;KPS评分改善率分别为64.29%和35.14%（P=0.01）.结论 阿米福汀联合FOLFOX4方案治疗晚期胃癌,较单用FOLFOX4方案,患者不良反应轻,生活质量改善明显.

Objective To evaluate the therapeutic efficacy and adverse reaction of amifostine combined with FOLFOX4 regimen for treatment of patients with advanced gastric cancer,and controlled with those of FOLFOX4 regimen alone. Methods 79 patients were randomized into two groups,All received FOLFOX4 regimen.To the treatment group （42 patients）, amifostine was administered additionally,while to the control group（37 patients）,no additional medication was given.The regimen was given every 4 weeks,All enrolled patients were evaluated for adverse reaction after 4 cycles of treatment.Results The response rate in the treatment group was 42.86% （18/42）,and in the control group 35.14%（13/37）,the differentce of response rates between the two groups was not statistical ly significant（P=0.483）,but the adverse reaction,which included leucopenia,nephrotoxicity and periph- eral neuritis,presented in the treatment group was greatly less than that in the control group （P〈0.05）,the KPS score improving rate in the two groups was 64.29% and 38.14% respectively（P=0.01）.Conclusion Amifostine in combining with FOLFOX4 regimen can evidently reduce the adverse reaction of chemotherapy in treating advanced gastric cancer,and could also improve the quality of life.