改良FOLFOX方案时辰化疗治疗晚期胃肠癌的临床观察  

Clinical Observation of Modified FOLFOX Chrono-chemotherapy for Advanced Gastrointestinal Cancer

作　　者：武海松 邢磊[1] 袁野[1] 

机构地区：[1]江苏省射阳县人民医院肿瘤中心,江苏盐城224300

出　　处：《肿瘤防治研究》2011年第8期944-946,共3页Cancer Research on Prevention and Treatment

摘　　要：目的探讨奥沙利铂(L-OHP)联合亚叶酸钙(LV)、5-氟尿嘧啶(5-Fu)的改良FOLFOX时辰化疗方案与L-OHP联合LV、5-Fu的标准FOLFOX4常规化疗方案治疗晚期胃肠癌的近期疗效及不良反应。方法 183例晚期胃肠癌患者随机分为时辰化疗组和常规化疗组,时辰化疗组92例予改良FOL-FOX方案时辰化疗,L-OHP85～100mg/m2,第1天,14∶00～18∶00,正弦曲线式输液泵静脉持续滴注,给药峰值在16∶00;LV200mg/m2,第1,2天,22∶00～10∶00;5-Fu 1 000mg/m2第1,2天,22∶00～10∶00,LV和5-Fu也均用上述正弦曲线式输液泵静脉持续滴注,凌晨04∶00达给药高峰。常规化疗组给予标准的FOLFOX4方案化疗(L-OHP85～100mg/m2,第1天静滴2小时;LV200mg/m2,第1,2天静滴2小时;5-Fu 400mg/m2,第1,2天静推,5-Fu 600mg/m2第1,2天持续静滴22小时。L-OHP于上午正常工作时间给药,LV于L-OHP给药结束后给药,5-Fu于LV结束后给药;两组病例化疗均每2周重复,每30天为1周期,至少2周期后对两组的近期疗效和不良反应进行统计、比较。结果时辰化疗组的有效率为65.2%,KPS评分平均升高分值为18.7,均明显高于常规化疗组(P<0.05)。时辰化疗组的各种不良反应均明显低于常规组(P<0.05)。结论改良时辰化疗方案与常规化疗方案相比有效率明显增高,不良反应发生率明显降低,并具有更好的可耐受性,值得临床推广。Objective To invasigate the efficacy and side effects differences between modified FOLFOX chrono-chemotherapy with oxaliplatin（L-OHP） combined with 5-fluorouracil（5-Fu） and folinic acid（LV） and standard FOLFOX4 chemotherapy with L-OHP,5-Fu and LV inadvanced gastrointestinal cancer.Methods One hundred and eighty-three patients with advanced gastrointestinal cancer were randomly divided into two groups：chrono-chemotherapy group and conventional-chemotherapy group.Ninety-two patients in chrono-chemotherapy group was infused L-OHP 85～100 mg/m2 from 14：00 to 18：00（day 1）,with the highest plasma drug level at 16：00;LV 200mg/m2 and 5-Fu 1000mg/m2 were administered from 22：00 to 10：00（day 1~2）,with the highest plasma drug level at 4：00 in the morning,using a sinusoidal infusion pump.91 cases in conventional-chemotherapy group were given standard FOLFOX4 conventional chemotherapy： L-OHP 85～100mg/m2 was infused for 2 hours（day 1）;LV 200mg/m2 for 2 hours（day 1~2）;5-FU 400mg/m2 was intravenously injected（day 1~2） and 600mg/m2 infused continuously for 22 hours（day 1~2）.L-OHP was administrated at normal working time,followed by LV,and then 5-Fu.Chemotherapy was given repeatedly every 30 days for at least 2 cycles.Result The effective rate in chrono-chemotherapy group was 65.2%,and the KPS score increased by 18.7,which were higher than those of Conventional chemotherapy group（P0.05）.The occurrence of adverse effects was obviously lower than that of conventional chemotherapy group（P0.05）.Conclusion Compared with the conventional chemotherapy regime,modified FOLFOX chrono-chemotherapy had a higher effective rate,lower occurrence of adverse effects and better tolerability,which deserves the clinical expansion.

关 键 词：晚期胃肠癌 时辰化疗 疗效 不良反应 

分 类 号：R730.53[医药卫生—肿瘤] R735.2[医药卫生—临床医学]