FOLFOX4与FLP方案治疗食管胃交界部癌和远端胃癌的疗效比较

Clinical effects of FOLFOX4 regimen versus FLP regimen for patients with gastroesophageal junction cancer or distal gastric cancer

目的:探讨临床中食管胃结合部癌和远端胃癌患者应用奥沙利铂+氟尿嘧啶+亚叶酸钙[oxaliplatin(O)+fluorouracil(5-FU)+leucovorin(L),FOLFOX4]方案与铂+氟尿嘧啶+亚叶酸钙[cisplatin(C)+5-FU+L,FLP]方案治疗的效果.方法:采取回顾性方法对我院2009-01/2010-12的48例食管胃结合部癌和52例远端胃癌患者应用FOLFOX4与FLP方案治疗的总生存期、无病生存期和不良反应进行观察.结果:食管胃结合部癌中FOLFOX4组和FLP组的总生存期(overall survival,OS)和无病生存期(disease-free survival,DFS)比较具有明显的差异(42.1 mo vs 25.2 mo,35.6 mo vs16.6 mo,P<0.05),统计学有意义;远端胃癌中FOLFOX4组和FLP组的OS和DFS比较无明显的差异(P>0.05),统计学无意义;食管胃结合部癌和远端胃癌患者中FOLFOX4组和FLP组的白细胞减少、血小板减少、中性粒细胞减小和转氨酶异常以及腹泻等发生率比较无明显的差异(P>0.05),统计学无意义;食管胃结合部癌中FOLFOX4组的恶心与呕吐均低于FLP组(20.0%vs 47.8%,P<0.05),统计学有意义;远端胃癌患者中FOLFOX4组的恶心与呕吐均高于FLP组(30.0%vs 9.1%,P<0.05),统计学有意义.结论:临床中对于食管胃结合部癌患者应用FOLFOX4化疗方案效果优于FLP化疗效果,远端胃癌患者应用FOLFOX4与FLP方案效果相似.

AIM： To investigate the clinical effects of oxaliplatin （O） ＋ fluorouracil （5-FU） ＋ leucovorin （L） （FOLFOX4） regimen versus cisplatin （C） ＋ 5-FU ＋ L （FLP） regimen in the treatment of gastroesophageal junction cancer and distal gastric cancer. METHODS： A retrospective analysis of 48 patients with gastroesophageal junction cancer and 52 patients with distal gastric cancer who were treated with the FOLFOX4 or FLP regimen at our hospital form January 2009 to December 2010 was performed. Overall survival, diseasefree survival and adverse reactions were compared between different groups. RESULTS： In patients with gastroesophageal junction cancer, the FOLFOX4 regimen was associated with significantly better overall survival and disease-free survival than the FLP regimen （42.1 mo vs 25.2 mo, 35.6 mo vs 16.6 mo, P 〈 0.05 for both）. In contrast, there were no significantly differences in overall survival and disease-free survival in patients with distal gastric cancer treated with the FOLFOX4 regimen and those treated with the FLP regimen （P 〉 0.05 for both）. In both patients with gastroesophageal junction cancer and those with distal gastric cancer, the incidence rates of leukopenia, thrombocytopenia, neutropenia, transaminase abnormalities and diarrhea （P 〉 0.05） showed no significant differences between the FOLFOX4 and FLP groups. In patients with gastroesophageal junction cancer, the incidence rate of nausea and vomiting was significantly lower in the FOLFOX4 group than in the FLP group （20.0% vs 47.8%, P 〈 0.05）. In distal gastric cancer patients, the incidence rate of nausea and vomiting was significantly higher in the FOLFOX4 group than in the FLP group （30.0% vs 9.1%, P 〈 0.05）. CONCLUSION： In patients with gastroesophageal junction cancer, the FOLFOX4 regimen has better efficacy than the FLP regimen; however, in patients with distal gastric cancer, the two regimens have similar effects.