全反式维甲酸联合诱导分化治疗晚期胃癌的初步临床观察

All-Trans-Retinoic Acid in Treatment of Gastric Cancer

目的:观察全反式维甲酸(ATRA)与5-FU和MMC联合治疗晚期胃癌的疗效。方法:治疗组5-FU加ATRA加MMC联合化疗:5-FU500～750mg/m2,第1～5天静滴,ATRA20mg,口服,每日3次,治疗28天;MMC6～8mg/m2,静推,每周2次。5-FU加ADM加MMC方案:5-FU500～750mg/m2,第1～5天静滴,ADM30mg/m2,静推,连用2日,MMC6～8mg/m2,静推,每周2次。联合化疗每28天重复为一周期;治疗二周期为一疗程。结果:5-FU加ATRA加MMC治疗15例胃癌的有效率为60.0%(9加15),5-FU加ADM加MMC治疗15例胃癌的有效率为40.0%(6加15)。前一方案的有效率高于后者(P<0.05),两者不良反应相似,但多数患者能耐受。另外,ATRA主要对高、中分化的胃癌作用明显。结论:ATRA与5-FU加MMC联用能明显提高化疗药物对高、中分化胃癌的疗效。

Objective:To study the effect and toxicity of ATRA in the treatment of gastric cancer.Methods:In treatment group:5-FU/ATRA/MMC regimen:5-FU at dose500～750mh/m 2 iv for1～5days;ATRA20mg tid;MMC6～8mg /m 2 iv twice a week.5-FU/ADM/MMC regi-men:5-FU500～750mg /m 2 +5%glucose500ml iv qd for1～5days;MMC6～8mg /m 2 +20ml normal saline iv twice a week;ADM30mg /m 2 +20ml normal saline intravenous injection for2days.The treatment was recycled every28days and each therapeutic course consisted of two cycles.Re-sults:The response rate of15gastric cancer patients treated by5-FU/ATRA/MMC was60.0%(9/15)which was much higher than that of15patients treated by5-FU/ADM/MMC(P<0.05).The adverse effects of5-FU/ATRA/MMC were the same as5-FU/ADM/MMC group.ATRA was effective mainly for high and middle differentiation gastric cancer.Conclusion:ATRA combined with5-FU/MMC is effective in treating high and middle differentiation advanced gastric cancer.