氟尿嘧啶长疗程辅以醛氢叶酸及顺铂治疗转移性结直肠癌32例

A Clinical Trial of Long Cycle Treatment by 5-Fluorouracil Combined with Leucovorin and Cisplatin for Metastatic Colon and Rectum Cancer

[目的]评价5氟尿嘧啶 (5 Fu)长疗程静滴并辅以醛氢叶酸 (CF)及顺铂 (DDP)治疗转移性结直肠癌的临床疗效及其毒性反应。[方法]CF100mg/m2dl～14 静脉滴注1h;5 Fu350mg/m2dl～14 静脉滴注6h～8h;DPP50mgd6 ,7 静脉滴注(水化)。28天为1周期 ,连用2个周期。[结果]肝转移灶1～2个 ,<2.5cm者12例 ,CR3例 ,PR4例 ;转移灶>3.0cm或多发转移灶者9例 ,PR3例 ;腹膜后淋巴结转移者7例 ,CR2例 ,PR2例 ;肺转移者2例 ,NC1例 ,PD1例 ;脑转移者2例 ,无效。32例中14例有效 ,有效率 (CR +PR)为43.7%。毒副反应主要是白细胞减少 ,发生率为40.7 % ,Ⅲ度以上仅6.3% ,血红蛋白下降及血小板减少分别为28.1%和18.7% ,100%发生静脉炎 ,较重者占34.4 % ,停药后局部涂以扶他林软膏逐渐恢复。对治疗满3年的29例病人随访3年 ,随访率100 % ,1年生存率81.3% ,2年生存率68.8% ,3年生存率53.1 %。[结论]5 Fu长疗程静脉滴注 ,辅以醛氢叶酸及顺铂治疗转移性结直肠癌疗效较好 。

To assess the efficacy and toxicity of a long cycle treatment by 5 fluorouracil(5 Fu) combined with leucovorin(CF) and cisplatin(DDP) for metastatic cancer of colon and rectum. CF 100mg/m2 d 1～14 iv for 1 hour; 5 Fu 350mg/m2 d 1～14 iv for 6～8 hours; DDP 50mg d6, 7 iv; 28 days were used for a cycles, two cycles continuously. There were 3 cases of CR and 4 cases of PR in 12 cases with 1 or 2 metastatic lesions <2.5 cm , 3 cases of PR in 9 cases with metastatic lesions >3 cm or multiple metastatic lesions ,2 cases of CR and 2 cases of PR in 7 cases with positive postperitoneal nodes,no response in 2 cases with lung metastasis , 1 case with NC, 1 case of PD in 2 cases with brain metastasis .Of 32 cases CR and PR was found in 14 cases (43.7%).The main side effect was leucocytopenia(40.70%),anemia (28.1%),thrombocytopenia 18.7%, severe phlebitis 34.4%.1_,2_,3_ year survival rates were 81.3%,68.8% and 53.1% respectively.[Conclusion] Long cycle treatment by 5 Fu combined with CF and DDP is effective and tolerant for metastatic colon and rectum cancers.