四氢叶酸钙、氟尿嘧啶大剂量双周疗法治疗晚期大肠癌的疗效研究

Study on the Therapeutic Efficacy of Advanced Large Intestinal Carcinoma Treated by Large Dose of CF and 5-FU Biweekly

目的评价四氢叶酸钙 (CF)、氟尿嘧啶 (5 Fu)大剂量双周疗法治疗晚期大肠癌的疗效及不良反应 ,为其在临床推广使用提供依据。方法将本院住院的晚期大肠癌病人 6 0例 ,随机分为两组 :A组采用大剂量CF(2 0 0mg/m2 )、5 Fu(3.0 g/m2 )持续滴注 4 8h ,每两周重复一次 ;B组采用CF(2 0 0mg/m2 )和 5 Fu(4 0 0mg/m2 )治疗 ,d1～ 5给药 ,每 4周重复一次。 5 8例病人接受了 2个月以上的治疗。结果A、B组总有效率分别为 33.3% (10 / 30 )和 2 1.5 % (6 / 2 8) ,A组优于B组 (P <0 .0 5 )。不良反应 ,A组病人以外周静脉炎最为明显 ,发生率为 80 .1% ,其中Ⅲ～Ⅳ度者占 33.4 % ,其次为粘膜炎和腹泻 ;白细胞、血色素和血小板下降分别占 6 .6 %、13.3%、13.4 %。B组病人外周静脉炎发生率为 14 .2 % ,白细胞、血色素和血小板下降分别占 7.1%、17.9%和 14 .4 %。A组与B组比较 ,除外周静脉炎的发生率差异有显著性 (P <0 .0 1) ,其他各项不良反应的总发生率均未见明显差异 ,(均P >0 .0 5 )。结论大剂量CF、5 Fu持续滴注的双周疗法治疗晚期大肠癌疗效较好 ,方案安全 。

ObjectivesTo evaluate the therapeutic efficacy and side effects in biweekly treatment of advanced large intestinal carcinoma with large dose of calcium tetrahydrofolate (CF) and 5 fluorouracil (5 Fu) aiming at offering evidence for its clinical application .MethodsSixty hospitalized patients were divided randomly into two groups:①Group A—infusion with large dose of CF(200 mg/m 2) and 5 Fu(3.0 g/m 2) was continued for 48 h biweekly;②Group B—CF(200 mg/m 2) and 5 Fu (400 g/m 2) was given from first to fifth day per 4 weeks. 58 patients were treated for more than two months.ResultsThe total effective rates in Groups A and B were 33.3%(10/30) and 21.5% (6/28) respectively , Group A being significantly higher than Group B (P<0.05) .Periphlebitis was the most common complication in group A, with an occurrence rate of 80.1% ; 33.4% of the patients suffered from Ⅲ～ Ⅳgrade . Mucositis and diarrhea came to the next ; decrease in WBC count, Hb and platelet count (PtC) amounted to 6.6%, 13.3% and 13.4% among the patients, respectively .The occurrence rate of periphlebitis in Group B was 14.2%, whereas their reduction of WBC ,Hb and PtC were 7.1%,17.9%, and 14.4% ,respectively. Excepting significant difference in periphlebitis occurrence (P<0.01), the rate of the other side effects revealed no obvious difference between both groups (P>0.05).ConclusionThe biweekly treatment of advanced large intestinal carcinoma with large dose of CF and 5 Fu is effective , safe. and beneficial to its clinical application. [