吉西他滨加低剂量5-氟尿嘧啶持续静脉输注治疗晚期原发性肝癌  

Gemcitabine plus continuous venous infusion of low-dose 5-fluorouracil in the patients with advanced hepatocellular carcinoma

作　　者：蒋太生 徐行[1] 朱海明[1] 王晓庆[1] 

机构地区：[1]江苏省高邮市中医院肿瘤科,江苏高邮225600

出　　处：《现代肿瘤医学》2008年第9期1577-1579,共3页Journal of Modern Oncology

摘　　要：目的:评价吉西他滨加低剂量5-氟尿嘧啶(5-Fu)持续静脉输注治疗晚期原发性肝癌(PHC)患者的疗效、临床受益反应(clinicalbenefit response,CBR)以及不良反应。方法:l5例晚期PHC患者,采用吉西他滨800-1000mg/m2,静滴,d1,8,5-Fu250mg/(m2.day)经锁骨下静脉持续输注12天,21天为一周期。结果:15例患者中,13例可以评价疗效,其中2例PR,6例SD,5例PD。患者的肿瘤进展时间(TTP)为1-6.2个月,中位TTP3.2个月。CBR率为60%(9/15)。主要毒副反应为骨髓抑制,Ⅲ度-Ⅳ度贫血3例(20%),Ⅲ度粒细胞减少和血小板减少各2例(13.3%)和1例(6.7%)。消化道反应较轻,Ⅲ度腹泻和口腔粘膜炎各1例(6.7%)。结论:吉西他滨加低剂量5-Fu持续静脉输注治疗晚期原发性肝癌有一定的疗效,CBR率较高,毒副反应可以耐受,在晚期PHC尚无特别有效治疗措施的情况下,值得临床试用。Objective：To evaluate the efficacy,clinical benefit response（CBR） and toxic reactions of gemcitabine combined continuous venous infusion（CVI） low -dose 5 -fluorouracil （5 -Fu） in the patients with advanced hepatocellular carcinoma. Methods：Fifteen patients with advanced hepatocellular carcinoma were treated with gemcitabine combined CVI low - dose 5 - Fu . The treatment consisted of a 30 - min infusion of gemcitabine at 800 - 1000 mg/m^2 on days 1,8 of a 21 -day cycle,and 5 -Fu given via a peripherally inserted subclavian vein at 250 mg/（ m^2 · day） continuously for 12 days, every 21 days. Results：There were 13 of the 15 patients could be evaluated for objective efficiency ,2 patients obtained partial response （PR）, 6 patents stable disease （SD）, 5 patients disease progression （PD）. Time to tumor progression （TrP） of the patients ranged from 1 to 6.2 months, median TrP 3.2 months. CBR rate was 60% （9/15）. All of the 15 patients might be evaluated for the toxic reactions. The major toxicity was myelosuppression, in which grade Ⅲ - Ⅳ anemia was observed in 3 patients（20% ） ,grade m neutropenia and thrombocytopenia in 2 patients（ 13.3% ） and 1 patient （6.7%） respectively . Gastrointestinal toxicity was mild, in which grade m diarrhea and oral mucositis was observed respectively in 1 patients（6.7% ）. Conclusion：Gemcitabine combined CVI low dose 5 - Fu was respectable efficacy in the patients with advanced hepatocellular carcinoma, with good CBR rate, and well tolerated.

关 键 词：原发性肝癌 吉西他滨 5-氟尿嘧啶 化疗 

分 类 号：R735.7[医药卫生—肿瘤]