草酸铂联合氟尿嘧啶/亚叶酸钙时辰治疗晚期胃癌的临床观察  

Oxaliplatin Combining 5-FU/Calcium Folinate for Advanced Gastric Cancer by Chrono-chemotherapy

作　　者：夏莉[1] 高峰[1] 倪志强[1] 张铁英[1] 尤君[2] 孙洪华[2] 

机构地区：[1]吉林省人民医院,长春市130021 [2]吉林省肿瘤医院,长春市130012

出　　处：《中国医院用药评价与分析》2008年第10期772-774,共3页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:关于探讨时辰化疗在晚期胃癌中的应用,观察近期疗效及不良反应。方法:44例晚期胃癌患者分为两组,一组22例患者采用时辰化疗组,而另一组22例患者采用常规化疗组。治疗组(时辰化疗组):L-OHP130mg.(m2)-1+5%葡萄糖500mL,d1,在14:00～17:00给药,持续3h静脉滴注,CF100mg.(m2)-1+5%葡萄糖250mL,d1～5,CF在5-FU前的20:00给药,静脉滴注2h,5-FU450mg.(m2)-1+5%葡萄糖500mL,d1～5,在22:00～次日10:00连续给药。对照组(常规化疗组):用药时间安排在正常上班时间8:00～17:00用药,L-OHP130mg.(m2)-1+5%葡萄糖500mL,d1,静脉滴注2h,CF100mg.(m2)-1+5%葡萄糖250mL,d1～5,CF在5-FU前给药,静脉滴注2h,5-FU450mg.(m2)-1+5%葡萄糖500mL,d1～5,静脉滴注3h,两组化疗前均给予阿扎司琼10mg或格拉司琼3mg预防性止吐,21d为1个周期。化疗2周期后评价近期疗效及不良反应。结果:近期疗效:时辰化疗组完成2周期患者共22例,CR+PR10例,有效率45.5%。常规化疗组完成2周期患者22例,CR+PR9例,有效率40.9%,两组无显著性差异(P>0.05)。不良反应:外周静脉炎,因时辰化疗组均采用深静脉插管,故避免了外周静脉炎的发生。时辰化疗组周围神经毒性、腹泻、粘膜炎发生率分别为31.8%、9.1%和4.6%,与常规化疗组77.3%、36.4%、36.4%相比较,有显著性差异(P<0.05)。未见肝肾功能、心功能损害。结论:应用草酸铂联合氟尿嘧啶和亚叶酸钙时辰治疗晚期胃癌疗效可靠,不良反应小,患者易耐受,尤其对于老年人更适合,并且可降低一定的医疗费用,值得临床推荐应用。OBJECTIVE： To study the application of chrono - chemotherapy in the treatment of advanced gastric cancer and to observe its short - term curative effect and toxic effects. METHODS ： 44 patients of advanced stage gastric cancer were randomly divided into 2 group： Trial Group （n = 22 ） received chrono - chemotherapy [ L - OHP 130 mg·（m^2）^-1 ＋ 5 % GLU 500 mL iv gtt. on day 1 from 14：00 to 17：00 plus CFIO0 mg·（m^2）^-1 ＋ 5% GLU 250 mL iv gtt from 20：00 to 22：00 for the first 5 days plus 5 - FU500 mg·（ m^2 ）^-1 ＋ 5 % GLU 500 mL ivgtt from 22 ： 00 to 10 ： O0 of next day for the first 5 days], and Control Group （n = 22） received routine chemotherapy group during office hours （8：00- 17：00） [ L- OHP 130 mg·（m2）-1 ＋5% GLU 500 mL, iv gtt on day 1 within 2 hours plus CF100 mg· （m^2）^-1 ＋ 5% GLU 250 mL ivgtt. within 2 hours for the first 5 days followed by 5 - FU500 mg·（ m^2 ）^-1 ＋ 5 % GLU 500 mL iv gtt within 3 h for the first 5 days]. Furthermore, two groups were assigned to receive Azasetron 10 mg or Granisetron 3 mg before chemotherapy to prevent vomiting. One course of treatment lasted for 21 days. After treatment for two cycles, the short - term curative efficacy and adverse effects were evaluated. RESULTS： There was no statistical difference between the two groups in short - term curative effect ： All the 22 patients in chrono - chemotherapy group finished the chemotherapy of 2 cycles （ 10 patients showed CR ＋ PR, with effective rate being 45.5 % ） and 22 patients in routine chemotherapy group finished chemotherapy of 2 cycles （ 9 cases showed CR ＋ PR, with effective rate being 40.9 % ） （ P 〉 0.05 ）. Toxicity and adverse reaction ： Peripheral phlebitis was avoided in chrono - chemotherapy group because they all deployed venous cannula. There were statistical differences between the two groups in incidence rates of peripheral neurotoxicity, diarrhea and blennymenitis （31. 8%, 9.1% and 4.6% respectively in chrono- chemot

关 键 词：时辰治疗 晚期胃癌 临床观察 

分 类 号：R979.1[医药卫生—药品]