沙利度胺联合FOLFIRI方案治疗晚期胃癌的临床观察

Clinical study of FOLFIRI plus Thalidomide in the treatment of advanced gastric cancers

目的观察沙利度胺联合FOLFIRI方案治疗晚期胃癌的临床疗效和毒副反应。方法沙利度胺200 mg,睡前顿服,1～10 d;伊立替康150 mg/m2,静脉滴注90 min,第1天;甲酰四氢叶酸(CF)200 mg/m2,静脉滴注2 h,第1、2天,;5-氟尿嘧啶(5-FU),400 mg/m2,静脉推注,第1、2天,;5-FU 600mg/m2静脉滴注22 h,第1、2天。每2周重复,4周期后评定疗效。结果全组43例患者均可评价疗效,其中CR 4例(9.30%),PR 21例(48.84%),SD 13例(30.23%),PD 5例(11.63%),总有效率RR(CR+PR)58.14%,1年生存率71.88%。主要毒副作用为腹泻(9.38%)、白细胞降低(46.88%)、恶心呕吐(28.13%)。结论该方案治疗晚期结直肠癌有效率高,明显减轻了毒副作用。

Objective To observe the therapeutic effects and adverse effect which consists of Thalidomide combined with FOLFIRI in treatment of advanced gastric cancers.Methods Thalidomide（200 mg/d,d1~10）,chemotherapy of regimen irinotecan 150 mg/m^2,90 minutes iv on day1,CF 200 mg/m^2,2 hours iv on day 1 to 2,followed by 5-FU 400 mg/m^2,iv and 600 mg/m^2,22 hours on day 1 to 2,two weeks as one circle.Efficacy was evaluated after 4 circles.Results 43 patients with advanced intestinal cancers received,4 patients achieved complete response（CR）,21 patients partial response（PR）,13 patients（30.23%） stable disease（SD）,5 patients（11.63%） progression disease（PD）.Overal response rate was 56.25%.1 year surrival rate was 71.88%.The major toxicity included diarrhea（9.38%） and leucopenia（46.87%）.Conclusion This study shows that the regimen of thalidomide combined FOLFIRI is effective and toxicity is reduced clearly in advanced intestinal cancers.