甲酰四氢叶酸加5-氟脲嘧啶48小时持续输注联合奥沙利铂治疗晚期大肠癌临床观察

Clinical observation of folinic acid、5-fluorouracil bolus continuously infusing 48 hours combining with oxaliplatin for patients with advanced colorectal carcinoma

目的 观察甲酰四氢叶酸 (CF)加 5 氟脲嘧啶 (5 FU) 4 8小时持续静脉输注联合奥沙利铂 (L OHP)治疗晚期大肠癌的临床疗效及主要毒副反应。方法 2 9例经病理确诊的晚期大肠癌患者予CF 2 0 0mg/m2 静脉滴注 2h后静推 5 FU 5 0 0mg ,而后用便携式静脉微量泵 4 8h持续输注 5 FU 2 4 g/m2 ,同时静滴L OHP 130mg/m2 ,每 2 1～ 2 8天为一周期 ,完成 2个周期后开始评价疗效。结果 全组 2 9例中 ,无完全缓解 (CR) ,部分缓解 (PR) 9例 ,稳定 (NC) 12例 ,进展 (PD) 8例 ,总有效率为 31 0 %。主要毒副反应为消化道反应及神经毒性 ,多为Ⅰ～Ⅱ度。并和既往 30例采用CF加 5 FU联合化疗的晚期大肠癌病例作对照分析。结论 甲酰四氢叶酸加 5 氟脲嘧啶 4 8h持续静脉输注联合奥沙利铂治疗晚期大肠癌 ,患者耐受性好 ,近期疗效好 ,值得临床推广。

Objective To observesion the clinical effect and main toxic reaction of folinic acid(CF)?5-fluorouracil(5-FU) bolus continuously infusing 48 hours combining with oxaliplatin(L-OHP) for patients with advanced colorectal carcinoma. Methods 29 patients be diagnosed through pathology with advanced colorectal carcinoma entered the study. CF 200 mg/m 2, iv infusion for 2 hours followed by 5-FU 500 mg, and 5-FU 2.4 g/m 2 continuously infusing 48 hours, combining with L-OHP 130 mg/m 2, iv infusion for 4 hours, repeated every 21～28 days. To evaluate the therapeutic effect. Results 29 cases were valuable and 9 had partial responses, 12 had no change, 8 had progressive disease. The total response rate was 31.0%. The main adverse reactions were reactions of digestive system and neuro-sensory toxicity. Most of them were Ⅰ～Ⅱ°. Compare with 30 cases with advanced colorectal carcinoma in the past treated with CF combing 5-FU. Conclusion The regiment of folinic acid? 5-fluorouracil bolus continuously infusing 48 hours combining with oxaliplatin may be safe and effective for patients with advanced colorectal carcinoma. It is worthwhile for furthermore clinical research.