CF加5-Fu持续滴注联合AM方案治疗中晚期原发性肝癌临床研究

Clinical study of the effect of calcium folinate,5-Fluorouracil bolus and continuous infusion combined with AM regimen in the treatment of advanced primary hepatocellular carcinoma

目的 观察大剂量醛氢叶酸 (CF)加氟尿嘧啶 (5 Fu)静脉持续滴注联合AM (ADM、MMC)方案治疗中晚期原发性肝癌临床疗效及不良反应 ,探索中晚期原发性肝癌较合理治疗方案。方法 本研究采用CF 2 0 0mg/m2 +5 Fu 3g/m2 持续滴注 4 8小时联合AM(ADM、MMC)方案治疗 35例中晚期原发性肝癌 ,对疗效及不良反应进行评价。结果 17例达部分缓解 (PR) ,15例为稳定 (SD) ,3例为进展 (PD) ,有效率为 4 8.6 %。不良反应主要为恶心呕吐、外周静脉炎、脱发、白细胞下降、口腔溃疡、腹泻等。上述不良反应绝大多数为Ⅰ～Ⅱ度反应 ,病人可耐受。结论 大剂量醛氢叶酸 (CF)加氟尿嘧啶 (5 Fu)静脉持续滴注联合AM方案治疗中晚期原发性肝癌疗效较好 ,不良反应较轻 ,值得在临床上推广应用。

Objective To observe the therapeutic effect and toxicity of high-dose-folinic acid plus 5-fluorouracil bolus and continuous infusion combined with AM regimen(Adriamycin、Mitomycin C) in advanced primary hepatocellular carcinoma. Methods Thirty-five patients with advanced primary hepatocellular carcinoma were treated with high-dose-folinic acid plus 5-fluorouracil bolus and continuous infusion 48 hours combined with AM regimen. The effect of treatment, toxicity was observed. Results There were seventeen partial responses, fifteen no changes and there progressive disease, in this objective response rate was 48.6% . The main side effects including、nausea and vomiting、peripheral phlebitis、alopecia、leukopenia、oral ulcer、diarrhea. All the side effects were tolerable and mild. Conclusion The results showed that high-dose-folinic acid plus 5-fluorouracil bolus and continuous infusion combined with AM regimen may be a safe and effective therapy for the patients with advanced primary hepatocellular carcinoma, It was worthy of clinical administration.