奈达铂联合亚叶酸钙、氟尿嘧啶治疗晚期胃癌29例临床观察

Clinical Observation of 29Patients with Advanced Carcinoma of Stomach Treated by Nedaplatin Combined with Calcium Folinate and Fluorouracil

目的观察奈达铂联合亚叶酸钙、氟尿嘧啶治疗晚期胃癌的疗效和毒性反应。方法将57例经病理学证实的晚期胃癌随机分为观察组与对照组,观察组29例,给予奈达铂80 mg/m2静脉滴注、d1,亚叶酸钙200 mg/m2静脉滴注、d2,氟尿嘧啶2000 mg/m248 h持续静脉滴注、d2。对照组28例,将奈达铂改为奥沙利铂130 mg/m2静脉滴注、d1,余药物、用法同观察组。4周为1个周期。2个周期后评价疗效。治疗期间观察并记录毒性反应。结果观察组有效率为55.2%(16/29),对照组有效率为42.9%(12/28),两组比较差异有统计学意义(P<0.05)。两组主要毒性反应为恶心、呕吐、黏膜炎、血液学毒性和神经毒性,其中对照组神经毒性反应发生率(67.9%)明显高于观察组(13.8%,P<0.01)。结论奈达铂联合亚叶酸钙、氟尿嘧啶对晚期胃癌有较好的近期临床疗效,毒性反应轻,患者耐受性好。

Objective To observe clinical efficacy and side effects of Nedaplatin combined with Calcium Folinate and Fluorouracil in treatment of advanced carcinoma of stomach. Methods 57 patients with advanced carcinoma of stomach were divided into therapy group （ n = 29 ） and control group （ n = 28 ）. In therapy group Nedaplatin （80 mg/m^2 ） was injected intravenously on the first day, calcium folinate （200 mg/m^2） the second day （d2） and fluorouracil （2000 mg/m^2 ,d2,48 h） were also injected intravenously. While in control group 28 patiens were injected intravenously with oxaliplatin （ 130 mg/m^2 , dl ） , calcium folinate （ 200 mg/m^2 , d2 ） and fluorouracil （ 2000 mg/m^2 , d2,48 h ） , with four weeks as one cycle. The efficacy was evaluated after two cycles, and side effects were evaluated. Results The effective rate was 55.2% （16/29） in therapy group and 42.9% （ 12/28 ） in control group. The differences were statistically significant （ P 〈 0.05 ）. The main toxicities reactions were nausea, vomiting, mucositis, hematologic toxicity and neurotox- icity. Incidence rate of peripheral neurotoxieity （67.9%） in control group was significantly higher than that in therapy group （ 13.8% ,P 〈 0.01 ）. Conclusion Nedaplatin combined with Calcium Folinate and Fluorouracil in treatment of advanced carcinoma of stomach can get better efficacy, little adverse reaction and better tolerance for the patients.