多柔比星脂质体对比表柔比星联合奥沙利铂、亚叶酸钙和氟尿嘧啶治疗晚期胃癌的临床观察  

Clinical observation of liposomal doxorubicin combined with leucovorin,5-fluorouracil and oxaliplatin in comparison with EOLF regimen for advanced gastric cancer

作　　者：王琼[1] 王南瑶[1] 曾洁[1] 盛华明[1] 费燕华[1] 吴丹[1] 

机构地区：[1]东南大学医学院附属江阴人民医院肿瘤中心,江苏江阴214400

出　　处：《临床肿瘤学杂志》2011年第6期542-545,共4页Chinese Clinical Oncology

摘　　要：目的比较多柔比星脂质体与表柔比星分别联合亚叶酸钙、氟尿嘧啶、奥沙利铂治疗晚期胃癌的疗效和毒副反应。方法 71例经病理学证实的晚期胃癌患者,随机分为治疗组36例,给予多柔比星脂质体30mg/m2,静脉滴注d1;亚叶酸钙150mg/m2,静脉滴注d1～d5;氟尿嘧啶400mg/m2,静脉滴注d1～d5;奥沙利铂130mg/m2,静脉滴注d1。对照组35例,将多柔比星脂质体改为表柔比星25mg/m2,静脉推注d1、d2,余药物、剂量和用法同治疗组。4周为1个周期。2个周期后评价疗效,每周期评价毒副反应。结果治疗组有效率(RR)为61.1%(22/36),疾病控制率(DCR)为77.8%;对照组RR为40.0%(14/35),DCR为51.4%;两组比较差异均有统计学意义(P=0.02,P=0.01)。治疗组中位TTP和中位OS分别为7.21个月和11.72个月,均高于对照组的5.41个月和8.17个月(P=0.042,P=0.031)。两组主要毒副反应为恶心呕吐、黏膜炎、脱发、血液学毒性及神经毒性,其中对照组恶心呕吐及脱发明显高于治疗组(P=0.01,P=0.0001)。结论表柔比星、亚叶酸钙、氟尿嘧啶和奥沙利铂对晚期胃癌有较好的近期临床疗效,应用多柔比星脂质体后可进一步提高疗效,改善患者的生活质量,减轻毒副反应,提高耐受性,值得进一步研究观察。Objective To compare the clinical efficacy,toxity and side effects in advanced gastric cancer patients treated by liposomal doxorubicin,leucovorin（CF）,fluorouracil（5-FU） and oxaliplatin（L-OHP） or EOLF regimen.Methods Seventy-one patients of advanced gastric cancer were divided into two groups,the treatment group（36 patients）： liposomal doxorubicin（30mg/m2） was injected intravenously on the first day,as well as CF（150mg/m2 d1-d5）,5-FU（400mg/m2 d1-d5） and L-OHP（130mg/m2 d1） were given.The control group（35 patients）： EPI（25mg/m2 d1-d2）,CF（150mg/m2 d1-d5）,5-FU（400mg/m2 d1-d5） and L-OHP（130mg/m2 d1） were given.Each regimen was done every four weeks as one cycle for each patient.The efficacy was evaluated after two cycles.Results The response rate（CR＋PR） of the treatment group was 61.1%（22/36）,which was higher than that in the control group（40.0%）.There were differences between the two groups（P=0.02）.The mean time to progression and mean overall survival time was 7.21 months and 11.72 months in treatment group,which was longer than that of control group（5.41 months and 8.17 months）,showing significant differences（P=0.042,P=0.031）.The major toxicities were nausea vomiting,mucositis,hair loss,hematologic toxicity and neurotoxicity.Compared to the control group,nausea vomiting and hair loss were much higher（P=0.01 and P=0.0001）.Conclusion EOLF regimen shows good efficacy in advanced gastric cancer.Liposomal doxorubicin combined with CF,5-FU and L-OHP regimen will further enhance the efficacy,including the better therapeutic effects,less adverse reaction and high quality life for the patients and it worth further study and observation.

关 键 词：多柔比星脂质体 表柔比星 晚期胃癌 化学治疗 

分 类 号：R735.2[医药卫生—肿瘤]