奥沙利铂联合ELF方案治疗进展期胃癌的疗效分析  

Oxaliplatin combined with ELF regimen in the treatment of patients with advanced gastric cancer

作　　者：楼芳[1] 朱艳虹[1] 潘宏铭[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院肿瘤中心 浙江大学邵逸夫临床医学研究所,浙江杭州310016

出　　处：《中华肿瘤杂志》2009年第1期75-78,共4页Chinese Journal of Oncology

摘　　要：目的观察奥沙利铂联合ELF（足叶乙甙＋亚叶酸钙＋5-氟尿嘧啶）方案治疗进展期胃癌的临床疗效和安全性。方法奥沙利铂100mg／m^2，静滴2h，第1天；亚叶酸钙200mg／m^2，静滴30min，第1-3天；5-氟尿嘧啶500mg／m^2，静滴2h，第1-3天；足叶乙甙100mg／m^2，静滴3h，第1-3天；每21d重复。治疗2个周期后，评价疗效和不良反应。结果入组的69例患者均经病理学确诊，其中胃腺癌57例，胃印戒细胞癌12例。42例为新诊断的患者，27例患者既往曾经接受过化疗。在可评价疗效的62例患者中，完全缓解（CR）7例，部分缓解（PR）25例，总缓解率为51.6％。中位疾病进展时间为5.7个月，中位生存时间为9.2个月。主要的血液学不良反应为贫血（29.0％）、白细胞减少（51.2％）和血小板减少（21.2％），无4-5度的血液学不良反应。最常见的非血液学不良反应有恶心（46.5％）、呕吐（41.1％）、外周感觉神经毒性（47.1％）以及2度脱发（27.3％）。结论奥沙利铂联合ELF方案治疗进展期胃癌疗效确切，不良反应发生率低，是值得推广验证的新联合化疗方案。Objective To evaluate the efficacy and safety of the combination of oxaliplatin and ELF （VP16/CF/5-Fu） regimen in the treatment of patients with advanced gastric cancer. Methods Oxaliplatin was given at a dose of 100 mg/m^2 i.v. 2 hours D1, calcium folinate （CF） 200mg/m^2 i.v. 1/2 hour D1-D3, 5-fluorouracil （5-Fu） 500 mg/m^2 i.v. 2 hours D1-D3 and etoposide 100 mg/m^2 i. v. 3 hours D1-D3. Cycles were repeated every 21 days. Efficacy and safety were evaluated every 2 cycles. Results Sixty-nine patients were enrolled into the study. All cases were pathologically confirmed as gastric cancer （adenocarcinoma in 57 cases and signet ring cell carcinoma in 12 cases）. 42 patients had newly diagnosed disease, and 27 patients had received previous chemotherapy. 62 patients were analyzed for response （7 complete responses and 25 partial responses） with total response rate 51.61%. The median time to progression was 5.7 months and the median overall survival was 9.2 months. The most common hematologic toxicities were anemia （29.0%） , leueopenia （51.2%） and thrombocytopenia （21.2%）. No grade 4 and grade 5 hematologic toxicities were observed. The most common non-hematologic toxicities were nausea （46.5%）, vomiting （41.1%）, peripheraJ sensory neuropathy （47.1%）, and grade 2 alopecia（27.3%） . Collusion This oxaliplatin combined with ELF regimen shows good efficacy and acceptable safety in advanced gastric cancer patients. It is worthy to be proved as a suitable alternative regimen in this indication.

关 键 词：奥沙利铂 胃肿瘤 化学疗法 

分 类 号：R686[医药卫生—骨科学]