ELFP方案治疗术后转移性胃癌42例临床疗效

Efficacy analysis of ELFP Regimen Chemotherapy in 42 Cases with Metastatic Gastric Carcinoma

目的：评价ＥＬＦＰ方案治疗术后转移性胃癌的疗效、毒副反应。方法：表阿霉素５０ｍｇ／ｍ２，第１天；顺铂８０ｍｇ／ｍ２，第 １天，醛氢叶酸 １２５ｍｇ／ｍ２，第 １～５天；氟脲嘧啶 ５００ｍｇ／ｍ２，持续静脉点滴 １２，小时，第１～ ５天， ２１天为一周期。结果：４２例中ＣＲＳ例（１１．９％），ＰＲ１９例（４５．２％），总有效率５７．１％。中位缓解时间为４个月。初治。复治有效率分别为７３．７％和４３．５％，Ｐ＜０．０５。不同病理类型有效率３３．３％～１００％，Ｐ＜０．０５。不同转移部位有效率０—８０．０％，Ｐ＜０．０１本方案剂量限制性毒性为骨髓抑制５７．１％，均为Ⅰ度至Ⅱ度。心脏节律改变１１．９％，Ⅳ度仅１例。结论：ＥＬＦＰ方案治疗转移性胃癌疗效较好，毒副反应可耐受，有临床应用价值。

Objective: To study the efficacy and the toxicity of combination chemotherapy including Epirubicin. Leucovorin. 5 - Fluorouracil. Cisplatin for metastatic gastric carcinoma. Methods: 42 cases of metastatic gastric carcinoma were treated with Epirubicin 50 mg/m2 iv. Cisplatin 80 mg/m2 iv on day1, Leucovorin 125 mg/m2.5 - Fluorouracil 500mg/m2 per day as continuous intravenous infusion for 12 hours on day1 - 5, repeat every three weeks. Results: there were complete response 11. 9 % (5/42 ), partial response 45. 2 % (19/42 ), with a total response rates was 57. 1 %, median time of remission 4 months. The RR of metastases of abdominal wall.lymph node.liver.ovary was 80. 0 % . 76. 2 % .61. 5 % and 60. 0 %, respectively(P < 0. 01 ). The response rate of undifferentiated. poorly differentiated adenocarcinoma. tubular adenocarcinoma. mucinous adenocarcinoma and signet - ring cell carcinoma was 100 % .68. 2% .66. 7% .40. 0% and 33. 3 %, respectively, (P< 0. 05 ). The RR was higher in previously untreated cases than in treated cases (73. 7 % .43. 5 %, respectively, (P < 0. 05 ). The dose limiting toxicity was myelosuppression with WHO grade I - II in 57. 1%, arrhythmia 11. 9%,grade IV only one, no chemotherapy - related death. Conclusion: these results suggest that ELFP regimen is well tolerated and effective for metastatic gastric carcinoma.