羟基喜树碱为主联合方案治疗晚期胃肠道肿瘤临床疗效观察

Clinical efficacy analysis of 5-FU+CF+HCPT+/-DDP Regimen in treatment of advanced Gastrointestinal cancer

目的:观察羟基喜树碱为主的联合方案治疗74例晚期胃肠道肿瘤的疗效及不良反应。方法:胃癌45例,醛氢叶酸(CF)200mg/m2,第1～5天;5-氟脲嘧啶(5-FU)500mg/m2,第1～5天;顺铂(DDP)40mg/m2,第1～3天,DDP应用当天水化;羟基喜树碱(HCPT)10mg/m2,第1～5天或隔日1次,连用7次;结、直肠癌29例,除不用DDP外,余同上。3～4周为1个周期。结果:74例中CR4例(5.4%),PR34例(46.%),SD14例(18.9%),PD22例(29.7%),总有效率为51.4%。中位缓解时间5.5个月。初治、复治有效率分别为67.9%和41.3%,P<0.05。胃癌,结、直肠癌有效率分别为53.3%及48.3%,P>0.05。不同病理类型有效率为20%～75%,P>0.05。不同转移部位有效率为0～71.4%,P<0.01。本观察组Ⅲ～Ⅳ度不良反应主要为胃肠道反应(16.2%)、外周血粒细胞下降(10.8%);其它有Ⅳ度化学性膀胱炎1例;Ⅲ度口腔炎2例。结论:HCPT为主的联合方案治疗晚期胃肠道肿瘤的疗效较好、不良反应可耐受,有进一步研究的价值。

Objective:To study the efficacy and the toxicity of5-FU+CF+HCPT+/-DDP regi-men in treatment of74cases of Advanced Gastrointestinal cancer.Methods:45cases of Advanced stomach cancer were treated with CF200mg /m 2 day1～5,5-Fluorouracil500mg /m 2 day1～5,Cis-platin40mg /m 2 day1～3,HCPT10mg /m 2 day1～5or15mg /m 2 qodx7.29cases of Intestines can cer,besides DDP,other is same.Repeat every3～4weeks.Results:Complete response4cases(5.4%),Partial response34cases(46.0%),Total response rates was51.4%.Response rates of ini -tial treatment and retreatment was67.9%and41.3%,P<0.05.Response rates of Stomach cancer and In testines cancer was53.3%and48.3%,P>0.05.Response rates of different differentiated was20%～75%,P>0.05.Response rates of different place was0～71.4%,P<0.01.The toxicity as myelosup pression with WHO gradeⅢ～Ⅳin10.8%,Nausea and vomit16.2%,No chemotherapy related death.Conclusion:These results show the Regimen is well tolerated and effective for Advanced Gastrointestinal tract cancer.