EPLF方案治疗胃癌远处转移临床疗效评价

Analysis of efficacy of EPLF regimen chemotherapy in treatment of 32 cases of advanced metastatic gastric carcinoma

目的评价EPLF方案治疗胃癌远处转移的疗效和毒副反应.方法表阿霉素(EPI)60mg/m2,静脉推注,第1天;顺铂(DDP)30 mg/m2,静脉滴入2 h,第1～5天;甲酰四氢叶酸钙(LV)150 mg/m2,静脉推注,第1～5天;氟尿嘧啶(5-Fu)500 mg/m2,静脉点滴,持续16 h,第1～5天.28 d为一周期.结果CR 3例(9.4%),PR 12例(37.5%),总有效率(CR+PR)46.9%(15/32).主要毒副反应为剂量限制性骨髓抑制,75.0%的患者出现白细胞下降,其中Ⅲ～Ⅳ度占15.6%(5/32),需要配合G-CSF的应用.心电图改变为2例.中位生存期为7.8个月.结论EPLP方案治疗胃癌远处转移疗效较好,毒副反应可耐受,可作为一线用药.

Objective To study the efficacy and the toxicity of chemotherapy including epirubicin,cispla-tin, leucovorin and 5-Fu in treatment of advanced gastric cancer. Methods Thirty-two patients with advanced gastric carcinoma received chemotherapy of EPLF regimen (epirubicin 60 mg/m2 iv, cisplatin 30 mg/m2 infusion for 2-hour on dl-d5,leucovorin iv 150 mg/m on dl-d5 and 5-Fu 500 mg/m continuous infusion for 16 hours on d1-d5, q28 d). Results The overall response rate was 46.9% (15/32), complete response rate was 9.4%(3/32) and the partial response rate was 37.5%(12/32) .The main toxicity was myelosuppression.Leukopenia was observed in 75.0% of the patients, but grade 3 and 4 in 15.6% . The overall median survival period was 7.8 months. Conclusion This study shows that the regimen of EPLF is effective and tolerable as first-line treatment of advanced gastric carcinoma.