氟尿嘧啶联合紫杉醇和奥沙利铂方案一线治疗晚期胃印戒细胞癌的疗效及安全性评价  

Efficacy and safety of fluorouracil/leucovorin-paclitaxel-oxaliplatin regimen(POF)in first-line treatment of advanced gastric signet ring cell carcinoma

作　　者：詹周伟 王晓杰[1] 余家密[1] 郑静娴[1] 黄于芳 郭增清[1] Zhan Zhouwei;Wang Xiaojie;Yu Jiami;Zheng Jingxian;Huang Yufang;Guo Zengqing(Department of Oncology,Fujian Provincial Cancer Hospital&Fujian Medical University Cancer Hospital,Fujian Fuzhou 350014,China)

机构地区：[1]福建省肿瘤医院,福建医科大学附属肿瘤医院肿瘤内科,福建福州350014

出　　处：《现代肿瘤医学》2020年第12期2103-2107,共5页Journal of Modern Oncology

基　　金：福建医科大学启航基金项目(编号:2017XQ1208)。

摘　　要：目的:评价氟尿嘧啶联合紫杉醇和奥沙利铂方案(POF方案)一线治疗晚期胃印戒细胞癌的临床疗效及安全性。方法:68例既往未接受过治疗的初治晚期胃印戒细胞癌患者一线采用POF方案化疗:紫杉醇135 mg/m^2静脉滴注3 h,亚叶酸钙400 mg/m^2(左亚叶酸钙200 mg/m^2)静脉滴注2 h,同步奥沙利铂85 mg/m^2滴注2 h,接着持续静脉滴注氟尿嘧啶2200~2400 mg/m^246 h(使用便携式泵),14天为一个周期。结果:所有患者均可评价安全性及生存期,66例患者可评价近期疗效。疾病控制率89.4%,客观缓解率48.5%。平均随访13.2个月,中位无进展生存时间(PFS)7.0个月(95%CI:6.85~7.15个月),中位总生存时间(OS)10.6个月(95%CI:9.86~11.3个月)。主要的III/IV级不良反应为中性粒细胞减少(22.1%)和外周神经毒性(10.3%)。结论:晚期胃印戒细胞癌患者一线应用POF方案治疗是安全、有效的。Objective:To evaluate the efficacy and safety profile of fluorouracil/leucovorin-paclitaxel-oxaliplatin(POF)regimen as first-line treatment for patients with advanced gastric signet ring cell carcinoma.Methods:Sixty-eight previously untreated patients with advanced gastric signet ring cell carcinoma were eligible for this study.The chemotherapy regimen consisted of a 3-hour infusion of paclitaxel(135 mg/m^2)followed by oxaliplatin(85 mg/m^2)and leucovorin(400 mg/m^2)/levoleucovorin(200 mg/m^2),administered simultaneously over a 2-hour infusion period,followed by an infusion of fluorouracil(2200~2400 mg/m^2)over a 46-hour period.This schedule was repeated every 2 weeks.Treatment was continued until disease progressed or intolerable toxicity occurred.Results:Sixty-eight patients were enrolled,all were assessable for safety and survival.Sixty-six patients were objectively assessable for tumor response.The disease control rate was 89.4%,and the response rate was 48.5%.The median progression free survival time was 7.0 months(95%CI:6.85~7.15 months),and the median overall survival time was 10.6 months(95%CI:9.86~11.3 months).The major grade III/IV toxic effects were neutropenia(22.1%)and peripheral neurotoxicity(10.3%).Conclusion:The POF regimen is feasible and shows promising efficacy against advanced gastric signet ring cell carcinoma.

关 键 词：晚期胃癌 印戒细胞癌 紫杉醇 奥沙利铂 氟尿嘧啶 化学疗法 

分 类 号：R735.2[医药卫生—肿瘤]