FOLFOX4与FLP方案在食管胃结合部癌辅助化疗中的疗效比较  

Comparison of efficacy between FOLFOX4 regimen and FLP regimen as adjuvant chemotherapy for carcinoma of esophagogastric junction

作　　者：杨子鑫[1] 王龙[1] 王玉栋[1] 左静[1] 刘巍[1] 王淑琴[1] 王玉华[1] 刘凤玲[1] 魏素菊[1] 

机构地区：[1]河北医科大学第四医院肿瘤内科,石家庄050011

出　　处：《肿瘤》2011年第9期851-855,共5页Tumor

摘　　要：目的:回顾性分析辅助化疗FOLFOX4方案与FLP方案治疗食管胃结合部癌根治术后患者的疗效和不良反应。方法:回顾性分析2007年3月-2009年10月共123例接受FOLFOX4方案(67例)或FLP方案(56例)辅助化疗的食管胃结合部癌根治术后患者。主要评价指标为无病生存期(disease-free survival,DFS)、总生存期(overall survival,OS)和不良反应。同时,对两组患者的疗效进行分层分析。结果:FOLFOX4方案组和FLP方案组的中位DFS分别为35.9和16.8个月(P=0.008),中位OS分别为41.3和25.6个月(P=0.013)。分层分析显示,男性、45～65岁、腺癌以及Ⅱ期或ⅢA期患者接受FOLFOX4方案术后辅助化疗较FLP方案更具生存优势。FOLFOX4和FLP方案均耐受良好,血液学不良反应发生率无明显差异。FOLFOX4方案组非血液学不良反应主要为外周神经毒性,FLP方案组主要为消化系统反应。结论:与FLP方案相比,FOLFOX4方案辅助化疗可明显延长食管胃结合部癌术后患者的DFS和OS,且不良反应可耐受。Objective：To retrospectively analyze the efficacy and toxicity of 5-fluorouracil/leucovorin（5-Fu/LV） plus oxaliplatin（FOLFOX4） versus 5-Fu/LV plus cisplatin（FLP） as adjuvant chemotherapy for carcinoma of esophagogastric junction（CEGJ）.Methods：The clinical information of one hundred and twenty-three patients with CEGJ who had accepted radical operation was collected from March 2007 to October 2009.These patients received either FOLFOX4 regimen（n = 67） or FLP regimen（n = 56）.The major measurements were disease-free survival（DFS） and overall survival（OS） as well as toxicity.The stratified analysis was performed to compare the treatment outcomes between the two groups.Results：For FOLFOX4 and FLP regimens,the median DFS were 35.9 months and 16.8 months,respectively（P=0.008）,and the median OS were 41.3 months and 25.6 months,respectively（P=0.013）.The stratified analysis showed that FOLFOX4 regimen as an adjuvant chemotherapy had significant survival advantages for patients who were male or 45-65 years old,or had adenocarcinoma or stage Ⅱ/ⅢA.The two regimens were both tolerable,and there was no difference in hematologic toxicitiy between the two regimens.The peripheral neurotoxicity was the major non-hematologic toxicity of FOLFOX4 regimen,while the gastrointestinal reaction was the major non-hematologic toxicity of FLP regimen.Conclusion：The results of this retrospective analysis indicate that FOLFOX4 regimen can prolong the DFS and OS of CEGJ as compared with FLP regimen,and the toxicities are tolerable.

关 键 词：癌 食管胃结合处 抗肿瘤联合化疗方案 辅助化疗 FOLFOX4方案 FLP方案 

分 类 号：R735.1[医药卫生—肿瘤] R735.2[医药卫生—临床医学]