奥沙利铂联合5-氟尿嘧啶、醛氢叶酸钙每周方案治疗晚期胃癌的初步临床研究  

Primary study on weekly oxaplatin plus 5-fluorouracil, and folinic acid in patients with advanced gastric carcinoma

作　　者：姜虹[1] 林万隆 王理伟[1] 周英[1] 高宇[3] 蒋燕华[1] 

机构地区：[1]同济大学附属东方医院肿瘤中心,上海200120 [2]上海市闸北区市北医院消化科,上海200435 [3]交通大学医学院,上海200025

出　　处：《世界肿瘤杂志》2006年第1期34-37,共4页Tumour Journal of the World

摘　　要：目的 观察奥沙利铂联合5-氟尿嘧啶、醛氢叶酸钙（FOLFOX）每周方案治疗晚期胃癌疗效和不良反应。方法 FOLFOX每周方案治疗26例晚期胃癌病人。L-OHP50mg／m^2＋醛氢叶酸钙500mg／m^2，静脉滴注，2h＋5-氟尿嘧啶2000mg／m^2，持续静脉注射，48h，d1，d8，d15，d22，5wk1个周期，至少2个周期。结果 26例晚期胃癌中，完全缓解（CR）1例（3．9％），部分缓解（PR）13例（50．5％），稳定（SD）5例（19．2％），进展（PD）7例（26．9％），总有效率为53．8％。中位生存期11．5（8．0-14．5）mo，肿瘤中位进展时间6．5（3．5-10．5）mo。最常见的不良反应为骨髓抑制、消化道反应以及神经感觉障碍，多为Ⅰ-Ⅱ度，无Ⅳ度不良反应发生。骨髓抑制以轻中度贫血为特点，对白细胞及血小板抑制较轻。消化道反应主要表现为恶心呕吐和腹泻，Ⅲ度腹泻发生率为19．2％。神经感觉障碍是L-OHP最主要不良反应，发生率高达61．5％。化疗间歇期可缓解。结论 FOLFOX每周方案是治疗晚期胃癌安全有效的化疗方案。Objective The aim of the study was to assess the efficacy and safety of weekly oxaliplatin, 5-fluorouracil and folinic acid （FOLFOX regimen） in patients with advanced gastric cancinoma, Methods Twenty-six patients with recurrent or metastatic gastric adenocarcinoma were enrolled and received oxaliplatin （50mg/m^2） plus folinic acid （500mg/m^2, 2h infusion） followed by 5-fluorouracil （2000 mg/m^2, 2411 infusion） on days 1,8,15 and 22 of a 5-week cycle. Results Of twenty-six patients enrolled, all were evaluated for response and toxicity. The overall response rate was 53.8% with complete and partial response rates of 3.9% and 50.0%, respectively. The median overall survival was 11.5 months, and the median time to tumor progress was 6.5 months. The regimen was given without any grade Ⅳ toxicity observed, but grade Ⅲ diarrhoea in 5 patients（19.2%）, grade Ⅲ anaemia in 2 patients, grade Ⅲ leukopenia, nausea and thrombocytopenia in 1 patient respectively. The most common non-hematologic toxicity encountered with this regimen was cumulative peripheral neuropathy, with 61.5% experiencing grade 1 or 2 toxicity. Conclusions The weekly oxaliplatin, folinic acid and 5-fluorouracil is well tolerable and shows notable activity as first-line treament in metastatic carcinoma of the stomach.

关 键 词：每周 奥沙利铂 5-氟尿嘧啶 醛氢叶酸钙 晚期胃癌 

分 类 号：R735.2[医药卫生—肿瘤]