低剂量奥沙利铂并氟脲嘧啶对晚期复发直肠癌放疗增敏作用的临床观察  

Radiochemotherapy with low-dose oxaliplatine, 5-Fu and leucovorin in advanced recurrent rectal cancer

作　　者：吕惠兰[1] 宫良平[1] 邵震宇[1] 殷进军[1] 王涛[1] 史斌 

机构地区：[1]山东大学齐鲁医院肿瘤中心放疗科,山东济南250012 [2]山东省临沂市肿瘤医院麻醉科,山东临沂276003

出　　处：《中国现代普通外科进展》2005年第3期178-179,182,共3页Chinese Journal of Current Advances in General Surgery

摘　　要：目的观察奥沙利铂(L OHP)并5氟脲嘧啶、甲酰四氢叶酸钙(5Fu/LV)配合放疗治疗晚期复发直肠癌患者的增效作用与毒性反应。方法23例无法手术的晚期复发直肠癌患者进行盆腔放疗,在放疗的第1、5周前一天开始给予L OHP30mg/m2静滴0.5h,LV100mg/m2和5Fu375mg/m2静滴4h,连用4d。25例单纯放疗者为对照组。结果放疗结束时,观察组局部症状缓解率较对照组高,尤其对会阴区下坠疼的改善明显(P<0.05),且转移症状亦有所缓解。两组有效率分别为78.3%、48%(P<0.05),完全缓解分别为8.7%、4.0%。主要毒副反应是消化道反应、神经毒性、静脉炎,骨髓抑制。结论利用低剂量L OHP并5Fu/LV的增敏作用配合放疗治疗晚期、复发直肠癌可提高近期疗效,改善症状,尤其对于伴远外转移者,为理想、安全的治疗手段。Objective： To evaluate oxaliplatine （L-OHP） with 5-Fu /leucovorin （5-Fu /LV）and concurrent radiation in advanced and recurrenced rectat cancer. Methods： 23 patients received radiotherapy administered to the pelvis. L-OHP30mg/（m^2 ·day） in 30min infusion,followed by bolus LV 100mg/（m^2·day） and 5-Fu 325 mg/（m^2·day）. All drugs were given 4 days during Week1 and 5 of standard radiotherapy. 25 cases with radiation alone were as control group. Results ：The remission rate of symptoms was higher in study group than in control 6roup, especially for perineal pain. The overall respond rates were 78. 396,4896 respectively（ P〈0. 05）. No patients developed Grade 4 acute toxicity. The main acute toxicities were 8astrointestinitis, neuro--sensory toxicity, bone marrow suPPression. Conclusion ： Low-- dose oxaliplatine plus 5-Fu and leucovorin combined with pelvic radiotherapy was more effective than radiation alone and was tolerated in patients with advanced and recurrenced rectal cancer.

关 键 词：直肠肿瘤 奥沙利铂 氟脲嘧啶 甲酰四氢叶酸钙 放射疗法 药物疗法 

分 类 号：R735.37[医药卫生—肿瘤]