改良FOLFOX方案一线治疗老年晚期胃癌的临床研究  

Clinical Trial of Modified FOLFOX Regimen as First-line Chemotherapy for Elderly Patients with Advanced Gastric Cancer

作　　者：赵建国[1,2] 王建芳[1,2] 吴东平[1,2] 项晓军[3] 张凌[3] 熊建萍[3] 

机构地区：[1]绍兴市人民医院 [2]浙江大学绍兴医院肿瘤内科,浙江绍兴312000 [3]南昌大学第一附属医院肿瘤科,南昌330006

出　　处：《中国药房》2015年第2期245-247,共3页China Pharmacy

摘　　要：目的：评价改良FOLFOX方案一线治疗老年晚期胃癌的疗效和毒副反应。方法：改良FOLFOX方案一线治疗63例老年（〉65岁）晚期胃癌患者。具体用法为奥沙利铂85 mg/m2,第1天,静脉滴注2 h;亚叶酸钙400 mg/m2,第1天,静脉滴注2 h;5-氟尿嘧啶2.6 g/m2,在亚叶酸钙滴注结束后立即持续泵入46 h。每2周重复,按实体瘤的疗效评价标准（RECIST）评价疗效。结果：63例患者共接受436个周期的化疗,均可评价疗效。完全缓解2例,部分缓解26例,疾病稳定21例,疾病进展14例,有效率为44.4%。中位疾病进展时间为6.3个月,95%置信区间（CI）4.74~7.86;中位生存时间为9.7个月,95%CI 8.14~11.26。毒性反应较轻,以Ⅰ、Ⅱ级为主,仅白细胞和中性粒细胞下降（11.1%和9.5%）、恶心（4.8%）、呕吐（6.3%）及腹泻（1.6%）等Ⅲ级毒性反应发生,均未发生Ⅳ级毒性反应。结论：改良FOLFOX方案一线治疗老年晚期胃癌疗效确切,不良反应轻。OBJECTIVE： To evaluate clinical efficacy and toxic side effect of modified FOLFOX regimen as first-line chemo- therapy for elderly patients with advanced gastric cancer （AGC）. METHODS： 63 patients aged more than 65 year-old with AGC re- ceived modified FOLFOX regimen, i.e. oxaliplatin 85 mg/m2 i.p. for 2 h on the 1st day; calcium folinate 400 mg/m2 i.p. for 2 h on the 1st day, followed by a 46 h infusion of 5-fluorouracil 2.6 g/m2; repeated every 2 weeks. Therapeutic efficacy was evaluated by RECIST. RESULTS ： 63 patients received 436 cycles of chemotherapy in total. All patients were available to evaluate therapeutic ef- ficacy. The total response rate was 44.4%, with 2 cases of complete responses, 26 cases of partial responses, 21 cases of stable dis- eases and 14 cases of progressions. Median time to progression was 6.3 months （95%CI： 4.74-7.86） and median survival time was 9.7months （95 % CI： 8.14-11.26）. Toxic reaction was fairly mild, mainly were grade I and II. Only aleukocytosis and neutropenia （11.1% and 9.5% ）, nausea （4.8%）, vomiting （6.3%） and diarrhea （1.6%） resulted in grade III toxicities; gradelVtoxicities had never been recoded. CONCLUSIONS： The modified FOLFOX regimen as first-line chemotherapy is effective actually for elderly patients with AGC with less ADR.

关 键 词：改良FOLFOX方案 老年晚期胃癌 奥沙利铂 亚叶酸钙 5-氟尿嘧啶 

分 类 号：R979.1[医药卫生—药品] R735.2[医药卫生—药学]