紫杉醇和5-氟尿嘧啶/醛氢叶酸双周疗法治疗晚期胃癌的初步报告

Preliminary Report of Semimonthly 5-Fluorouracil/Leucovorin Combined with Paclitaxel in Treatment of Advanced Gastric Cancer(AGC)

背景与目的:已有的Ⅱ期临床研究显示,紫杉醇是治疗晚期胃癌的有效药物,紫杉醇和5-氟尿嘧啶(5-fluorouracil,5-FU)联合化疗治疗晚期胃癌疗效好、不良反应轻。本研究拟观察应用紫杉醇和5-FU/醛氢叶酸(leucovorin,LV)双周疗法治疗晚期胃癌的疗效及不良反应。方法:选取病理检查证实的晚期胃癌患者25例,所有患者均有可评价病灶。治疗方案为紫杉醇75mg/m2,静脉滴注3h;LV200mg/m2,静脉滴注2h;5-FU375mg/m2,静脉推注10min;5-FU2.8g/m2,静脉灌注48h。以上方案每2周重复1次,每2次为1个疗程,所有患者至少接受2个疗程的治疗。结果:经过2个疗程的化疗后,完全缓解(completeremission,CR)率为8%(2/25),部分缓解(partialremission,PR)率60%(15/25),中位缓解期4个月。无治疗相关死亡,主要不良反应为静脉炎、感觉异常和脱发。结论:紫杉醇和5-FU/LV双周疗法治疗晚期胃癌患者,缓解率较高、不良反应患者可耐受。

BACKGROUND &OBJECTIVE: Phase Ⅱclinical trails showed that paclitaxel is effective in treatment of advanced gastric cancer (AGC). The combination of paclitaxel and 5 fluorouracil (5 FU) in the treatment of advanced gastric cancer is effective and safe. This study was designed to evaluate the efficacy and the toxicity of paclitaxel combined with semimonthly 5 FU/Leucovorin for the AGC patients. METHODS: Twenty five measurable patients with AGC proved pathologically were enrolled into this study. The chemotherapy regimen was comprised of paclitaxel,75 mg/m2 i.v. in a 3 hour infusion followed by 2 hour infusion of leucovorin 200 mg/m2, then 10 minute intravenous bolus of 5 FU 375 mg/m2, then 48 hour infusion of 5 FU 2.8 g/m2 using an ambulatory pump. The regimen was given per 14 days. One cycle consisted of twice chemotherapy regimens. All enrolled patients received at least two cycles of treatment. RESULTS: After two cycles of chemotherapy, the complete remission and the partial remission were 8%and 60%, respectively. The median duration of response was 4 months. No treatment related death occurred. Phlebitis,feeling disorder, and alopecia were main side effects. CONCLUSION: Semimonthly 5 FU/LV combined with paclitaxel has high release rate but comparatively mild toxicity for AGC patients.