FOLFOX4方案治疗晚期胃癌的临床观察

Clinical Study of FOLFOX4 Chemotherapy Regimen for Advanced Gastric Cancer

目的:观察FOLF0X4方案治疗晚期胃癌的近期疗效和毒副反应。方法:26例晚期胃癌患者,采用FOLFOX4方案,即:奥沙利铂(L-OHP)85mg/m^2静脉点滴2小时,第1天;亚叶酸钙(CF)200mg/m^2静脉点滴,2小时,第1,2天;氟脲嘧啶(5-Fu)400mg/m^2静脉推注,第1,2天,5-Fu 600mg/m^2微泵持续静脉滴注22小时,第1,2天;2周重复。4个周期后评价疗效和毒性。结果:全组26例均可评价,其中完全缓解(CR)1例,部分缓解(PR)13例,无变化(NC)8例,进展(PD)4例,总有效率(CR+PR)46.1%。中位生存时间(MST)为10个月。毒副反应主要是骨髓抑制,中性粒细胞减少发生率达84.6%,其次为胃肠道反应,恶心呕吐发生率88.5%,腹泻46.1%,无Ⅲ度～Ⅳ度胃肠道反应;本组患者未见明显心功能及肝肾功能损害。结论:FOLFOX4方案治疗晚期胃癌的近期疗效较好,毒副反应可以耐受,值得进一步研究应用。

Objective： To evaluate the efficacy and adverse effects of oxaliplatin combined with 5-fluorouracil（5-Fu） and calcium folinate in the treatment of patients with advanced gastric cancer. Methods： Twenty six patients with advanced gastric cancer re- ceived chemotherapy of regimen L-OHP 85mg/m2 2 hours dl, CF 200mg/m2 2 hours dl, d2 followed by 5-Fu 400mg/m2 iv and 600mg/m2 22 hours civ dl, d2 ; two weeks as one cycle. Efficacy was evaluated after 4 cycles. Results： One patient achieved complete response（ CR）, 13 patients partial response（PR） ,8 patients no change（NC） and 4 patients progression disease（PD）. Overall response rate was 46. 1%. The major toxicity included nausea, vomiting and myelosuppression. Conclusion： This study shows that the regimen of FOLFOX4 is effective and tolerable in advanced gastric cancer.