奥沙利铂联合亚叶酸钙和5-氟尿嘧啶治疗晚期胃癌的研究  

Oxaliplatin in combination with LV5FU2 for advanced/metastatic gastric cancer-a multicenter study

作　　者：金懋林[1] 陈强[2] 程凤歧[3] 陈伟[4] 陈黎[5] 潘良熹[6] 杨宇飞[7] 

机构地区：[1]北京大学临床肿瘤学院北京肿瘤医院北京市肿瘤防治研究所,100036 [2]上海第二医科大学新华医院 [3]解放军总医院 [4]深圳市肿瘤研究所 [5]山东省肿瘤防治研究院 [6]江苏省肿瘤医院 [7]中国中医研究院西苑医院

出　　处：《中华肿瘤杂志》2003年第2期172-174,共3页Chinese Journal of Oncology

摘　　要：目的　评价奥沙利铂联合亚叶酸钙、5 氟尿嘧啶 (OXA LV5FU2 )方案治疗进展及转移胃癌的疗效与安全性。方法　奥沙利铂 (OXA) 10 0mg/m2 ,静脉滴注 2h ,第 1天 ;亚叶酸钙 (LV) 2 0 0mg/m2 ,静脉滴注 2h后推注 5 氟尿嘧啶 (5 Fu) 4 0 0mg/m2 ,后续 5 Fu 6 0 0mg/m2 ,静脉持续输注 2 2h ,第 1,2天。每 2周重复 ,行 4周期 (8周 )治疗后判定疗效。结果　入组观察 4 3例 ,其中行原发灶切除者 17例 ,未切除者 2 6例。可评价疗效者 4 0例 ,其中完全有效 (CR) 4例 (10 .0 % ) ,部分有效 (PR) 13例(32 .5 % ) ,稳定 (SD) 17例 (4 2 .5 % ) ,进展 (PD) 6例 (15 .0 % )。总有效率 (ORR) 4 2 .5 % (17/ 4 0 ) ,初治 (一线 )ORR 5 0 .0 % (14 / 2 8) ,复治 (二线以上 )ORR 2 5 .0 % (3/ 12 )。中位无进展期 (mTTP) 5个月 ,中位总生存期 (mOS) 8个月。 4 3例中不良反应为 3或 4度者 12例 ,其中白细胞减少 7例 (16 .3% ) ,血小板减少3例 (7.0 % ) ,恶心呕吐和转氨酶升高各 1例 (2 .3% )。无化疗相关死亡。结论　OXA LV5FU2方案治疗晚期胃癌疗效较高 ,不良反应轻而且安全。Objective To evaluate the effects and safety of OXA LV5FU2 regimen for patients with advanced/metastatic gastric cancer. Methods OXA 100 mg/m 2 iv 2hr d1, LV200 mg/m 2 iv 2hr followed by 5 Fu 400 mg/m 2 iv bolus and 5 Fu 600 mg/m 2 iv 22hr d1, 2 were given, and repeated every 2 weeks. Efficacy was evaluated at 4 cycles (8 weeks). Results Forty three patients have been entered into the study. Patients with primary tumor resected or non resected were 17 and 26. The evaluable lesions were 26 primary lesions, 22 lymph node metastases, 12 liver metastases, 1 pancreas metastasis and 2 soft tissue metastases. Forty patients were evaluable for clinical response. Four patients achieved CR (10.0%),13 PR (32.5%),ORR 42.5% (95% CI 27.2 57.8),17 SD (42.5%) and 6 PD (15.0%). Overall response rate (ORR) for chemotherapy naive (1 st line) and pretreated (2 nd line) patients were 50.0% (14/28) and 25.0% (3/12), respectively. Median time to progress (mTTP) was 5 months and median overall survi al (mOS) was 8 months. Forty three patients were evaluable for toxicity, with Grade 3, 4 WHO toxicity of neutropenia in 7 patients (16.3%), thrombocytopenia in 3 patients (7.0%), nausea/vomiting in 1 patient (2.3%). There were no Grade 3, 4 peripheral neuropathy toxicity or any deaths during treatment. Conclusion OXA LV5FU2 is a high response regimen for advanced gastric cancer with mild toxicity , which can be practiced safely.

关 键 词：晚期胃癌 化学疗法 奥沙利铂 亚叶酸钙 5-氟尿嘧啶 OXA-LV5FU2方案 

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