5-氟尿嘧啶为主方案治疗晚期贲门癌及预后因素分析  

Regimens based on 5-fluorouracil in advanced cardiac cancer and analysis of prognostic factors

作　　者：江艺[1] 邱希辉[1] 陈志明[1] 林丹霞[1] 

机构地区：[1]汕头大学医学院附属肿瘤医院内科,广东汕头515041

出　　处：《中华肿瘤防治杂志》2007年第16期1257-1259,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：采用以5-氟尿嘧啶（5-FU）为主的LF、PLF方案治疗晚期贲门癌，通过对其近期疗效、毒副反应及生存预后的分析，探讨晚期贲门癌的治疗与预后因素。34例晚期贲门癌患者进行非随机分组治疗，LF组：醛氢叶酸（LV，200mg／m^2，d1）静脉滴入2h加5-FU0．5g静脉推注及5-FU3．0g／m^2持续48h静脉滴入，2周重复；PLF组：醛氢叶酸（LV，200mg／m^2，d1）静脉滴入2h加5-FU0．5g静脉推注及5-FU3．0g／m^2持续48h静脉滴入联合顺铂（DDP，25mg／m^2，d1～d3）静脉滴入，3周重复。34例患者总有效率为47．06％，LF、PLF两组有效率分别为37．50％和55．56％，P=0．327；主要的不良反应为恶心呕吐、脱发、口腔黏膜炎、白细胞下降、血红蛋白下降等；上述毒副反应大多数为Ⅰ、Ⅱ度反应，且发生率不高，经常规对症治疗后见好转。全组中位生存期为8．0个月，LF、PLF组的中位生存期分别为5．0和12．4个月，P=0．4642。在预后方面，治疗前KPS评分、化疗疗程数是影响预后的相关因素（P值分别为0．016和0．001）。初步研究结果提示，以5-FU为主的LF、PLF方案治疗晚期贲门癌疗效和安全性好，PLF方案可推荐为晚期贲门癌化疗的一线治疗。治疗前KPS评分、化疗疗程数是影响预后的独立因素。The objective of this study was to evaluate the efficacy and safety of LF and PLF regimens based on 5-fluorouradl in advanced cardiac cancer, and to explore the prognostic factors of advanced cardiac cancer by survival analysis. The patients with advanced cardiac cancer were enrolled in the study,and nonrandomly assigned to receive a 2-hour infusion of folinic acid 200 mg/m^2 followed by a 5-FU bolus 400 mg/m^2 and 48-hour infusion 3.0 g/m^2 every 2 weeks （LF） or a 2-hour infusion of folinic acid 200 mg/m^2 followed by a 5-FU bolus 400 mg/m^2 and 48-hour infusion 3.0 g/m^2 combined with DDP 25 mg/m^2 from d1 to d3 every 3 weeks （PLF）. Thirty-four patients were enrolled. The total response rate was 47.06%, and the response rates of LF and PLF regimens were 37. 50% and 55. 56% （P= 0. 327）, respectively. The main side effects included nausea-vomiting, alopecia, bone marrow suppression and mucositis. The LF regimen was milder than PLF regimen in leucocytopenia and alopecia. After a median follow-up of 8. 0 months, the overall median survival was 8. 0 months, the median survivals of LF and PLF were 12. 4 and 5.0 months（P=0. 464 2）, respectively. A highly significant correlation was noted between poor-prognosis and poor performance status （P= 0. 016） before chemotherapy and patients took less cycles of chemotherapy （〈4, P = 0. 001 ） by COX regression analysis. In conclusion, LF and PLF regimens based on 5-FU are active and well tolerable in advanced cardiac cancer. The PLF regimen can be recommended for advanced cardiac cancer as first-line treatment because of tolerable and more active. Poor performance status and taking less cycles of chemotherapy indicate poor prognosis.

关 键 词：胃肿瘤/药物疗法 醛氢叶酸 5-氟尿嘧啶 顺铂 

分 类 号：R735.2[医药卫生—肿瘤]