重组人血管内皮抑素联合化疗治疗晚期胃肠道癌临床观察  

Clinical observation of recombinant human endostatin combined with chemotherapy in treatmentof advanced gastrointestinal

作　　者：高绍荣[1] 夏海平 徐红燕[1] 殷军蕾 郭辉[1] 

机构地区：[1]山东省威海市立医院,264200 [2]解放军第404中心医院

出　　处：《中国实用医刊》2013年第4期13-15,共3页Chinese Journal of Practical Medicine

摘　　要：目的观察重组人血管内皮抑素（恩度）联合化疗治疗晚期胃肠道癌患者的临床疗效和不良反应。方法16例晚期胃肠道癌患者均经病理组织学或细胞学检查证实为腺癌，恩度15mg静脉滴注，每日1次，连续14d；联合化疗方案：FOLFIRI：伊立替康180mg／m2，90min滴完，LV（CF）200mg／m2静脉滴注，第1天（d1），5-氟尿嘧啶（5-Fu）400mg／m2，静脉滴注，d1，5-Fu2400mg／m2，持续静脉泵入46h；FOLFOX4：奥沙利铂（L·OHP）135me／m2，静脉滴注2h，dl；亚叶酸钙（CF）200mg／m2，静脉滴注，d1，氟尿嘧啶（5-FU）400mg／m2，dl，静脉推注后予以2400mg／m2持续静脉滴注46h。XELOX：希罗达1500me／m2，分两次口服，d1～14，奥沙利铂（L—OHP）135me／m2，静脉滴注2h，dl，改良的方案是把上述两方案中的氟尿嘧啶换成替加氟1．0g，静脉滴注，d1～5。常规在化疗前静脉注射昂丹司琼8mg预防呕吐，化疗后扶正、减毒、对症、支持治疗。每周期21d，连用4—6个周期，每2个周期行疗效评价。结果本研究有效率为43．75％，疾病控制率为81．25％。不良反应主要为骨髓抑制、胃肠道反应、乏力、心脏毒性及外周神经毒性。结论初步观察表明，恩度联合化疗治疗晚期胃肠道癌具有较好的疗效，不良反应低，耐受性好，值得进一步研究。Objective To observe the clinical effect and drug safety of endostar combined with chemotherapy in treatment of advanced gastrointestinal cancer. Methods Sixteen cases of advanced gas- trointestinal cancer were confirmed for adenocarcinoma by pathological or cytologic examination. Endostar 15 mg was given by intravenous drip, once a day for 14 days. Chemotherapy regimen： FOLFIRI： Irinote- can（ 180 mg/m2） iv infusion for 90 min; LV（CF） 200 mg/m2, iv, dl; 5-Fu 400 mg/m2, iv, dl; 5-Fu 2400 mg/m2, Continued vein pump into for 46 h. FOLFOX4 ： L-OHP 135 mg/m2, iv for 2 h, dl ; CF 200 mg/m2, iv, dl ; 5-FU 400 mg/m2,dl, continued intravenous drip into with 2400 mg/m2 for 46 h af- ter intravenous push. XELOX： Capecitabine 1500 mg/m2, twice a day, dl-dl4; L-OHP 135 mg/m2,iv infusion for 2 h, dl. The improved scheme is changing 5-Fu of above two schemes into Tegafur 1.0 g, iv, dl-5. Ondansetron 8 mg was intravenously injected before chemotherapy to prevent vomiting. After chemotherapy, do the strengthening the body resistance, attenuation, symptomatic and supportive treat- ment, 21 d each cycle, continuous for 4 -6 cycles. Do effect assessment each 2 cycle. Results Among the 16 cases, RR（CR ＋ PR） was 43.75% and DCR was 81.25%. The main adverse effects were bone marrow suppression, gastrointestinal reaction, lack of power, heart toxicity and peripheral neurotoxicity. Conclusions Preliminary observation showed that endostar combined with chemotherapy regimen in treatment of advanced gastrointestinal cancer has advantages of good therapeutic effects and less adverse reaction for the patients and it worth further study.

关 键 词：重组人血管内皮抑素(恩度) 胃肠道癌 靶向治疗 化学治疗 

分 类 号：R734.2[医药卫生—肿瘤]