草酸铂联合方案治疗晚期复治胃肠道癌的临床观察

Oxaliplatin combined with fluorouracil and calaium folinate in the treatment of patients with advanced and pretreated gastroinstestinal cancer

目的 :研究奥沙利铂 (L- OHP)与氟尿嘧啶 (5 - Fu)、甲酰四氢叶酸钙 (CF)联合方案治疗晚期并含 5 - Fu方案化疗失败的胃癌和大肠癌的疗效和毒副反应。方法 :L- OHP35 mg/ m2 ,静脉滴注 4 h,d1～ d4 ;5 - FU 5 0 0 mg/ m2 ,静脉滴注 4 h(接 L-OHP) ,d1～ d4 ;CF10 0 mg/ m2 ,静脉滴注 4 h(5 - Fu与 CF从 Y型管同时滴注 ) ,d1～ d4 ,2 1或 2 8天为 1周期。结果 :共治疗 2 2例患者 ,CR1例 ,PR6例 ,SD8例 ,PD7例 ,有效率为 31.8%。各病种的疗效为 :胃癌 2 / 4例 ,大肠癌 2 7.8% (5 / 18)。中位有效缓解期为4个月 (范围 2～ 7个月 )。有 5 4 .5 % (12 / 2 2 )患者在治疗后原有的临床症状有不同程度的改善。主要不良反应为贫血、白细胞和血小板减少、恶心呕吐、口腔炎及末梢神经炎 ,多为 1～ 2度。结论 :奥沙利铂与 5 - Fu、CF联合应用治疗晚期、复治的胃肠道癌疗效确切 。

Objective:To study the response and toxicity of the regimen of oxaliplatin (L OHP) combined with fluorouracil(5 Fu) and calcium folinate(CF)in the treatment of advanced and pretreated gastrointestinal cancer Methods:22 cases with advanced,failed previous 5 Fu based chemotherapy gastrointestinal cancer (including 4 patients with gastric cancer and 18 patients with colorectal cancer)were treated with:L OHP 35mg/m 2 iv infusion for 4 h D1 to D4,followed by 5 Fu 500mg/m 2 for 4h D1 to D4,and CF 100mg/m 2 for 4h D1 to D4(5 Fu and CF were infused at the same time),repeated every 3 or 4 weeks Results:The total response rate was 31 8%,the main side effects were bone marrow suppression,nausea and vomiting,oral mucositis and peripheral sensory neuropathy.The whole toxicity was mild and tolerable Conclusion:The regimen of L OHP combined with 5 Fu/CF was effective and well tolerable in the treament of patients with advanced and pretreated gastrointestinal cancer