含奥沙利铂方案治疗晚期胃癌的临床观察  

Clinical Results of Advanced Gastric Cancer Patients Treated with Oxaliplatin- Containing Regimen

作　　者：张为民[1] 徐光辉[1] 巨爱平[1] 郑义同[1] 蒋芹[1] 

机构地区：[1]连云港市第一人民医院,江苏连云港222002

出　　处：《癌症》2003年第12期1346-1348,共3页Chinese Journal of Cancer

摘　　要：背景与目的:体外实验证明奥沙利铂(oxaliplatin,L-OHP)能明显抑制胃癌细胞株的生长,并与绝大多数抗癌药物具有相加或协同细胞毒作用。本研究观察L-OHP联合醛氢叶酸(leucovorin,LV)、5-氟尿嘧啶(5-fluorouracil,5-FU)和足叶乙甙(etoposide,VP-16)作为一线方案治疗晚期胃癌的疗效和毒性,并与传统化疗方案进行对比。方法:采用非随机分组方法将48例晚期胃癌患者分为两组,即L-OHP+LV+5-Fu+Vp-16方案组(治疗组)25例和DDP+LV+5-Fu+Vp-16方案组(对照组)23例。L-OHP135mg/m2,静滴,第1天(对照组则为DDP20mg,静滴,第1～5天);LV200mg,静滴,第1～5天;5-FU500mg/m2,静滴,维持6h,第1～5天;VP-16100mg,静滴,第1～5天。3～4周为1疗程。结果:治疗组有效率64.0%(16/25),对照组有效率34.8%(8/23),治疗组有效率高于对照组,两组差异有显著性(P<0.05,χ2检验)。治疗组患者的中位生存期为11.5个月,1年生存率为45.6%;对照组患者的中位生存期为10.5个月,1年生存率为36.5%,治疗组中位生存期、1年生存率均高于对照组,但无统计学意义(生存期P>0.05,log-rank检验)。治疗组周围感觉神经症状的发生率较对照组高(P<0.05,秩和检验),恶心、呕吐的发生率较对照组低(P<0.05,秩和检验),其余不良反应两组之间无显著性差异。BACKGROUND &OBJECTIVE: In vitro clinical research showed oxalip la tin (L-OHP) could obviously suppress the growth of gastric cancer cells in comb ination with most anti-cancer drugs and help these drugs to kill the tumor cell s. This study was designed to evaluate the response and tolerance of oxaliplatin ,leucovorin (LV), 5-fluorouracil (5-FU),and etoposide (VP-16) as first-line regimen in advanced gastric cancer, and compare with traditional chemotherapy re gimen. METHODS: Forty-eight patients with advanced gastric cancer were divided into treatment group (L-OHP+LV+5-FU+VP-16) and control group(DDP+LV+5-F U+VP-16) using non-randomized method. L-OHP:135 mg/m2, iv infusion 2 hours, d1(or DDP 20 mg, iv infusion, d1-5); LV:200 mg,iv infusion,d1-5; 5-FU:500 mg/ m2 CI 6 hours on d1-5; VP-16: 100 mg, iv infusion d1-5. Every course lasted 3 -4 weeks. RESULTS: The response rate was 64%(16/25) in treatment group (25 cas es) and 34.8%(8/23) in control group (23 cases). The statistic difference was s een in two groups (P< 0.05, Chi-square test). The median survival and 1-year s urvival rate were 11.5 months and 45.6%for treatment group versus 10.5 months a nd 36.5%for control group. There was no statistical difference in two groups fo r overall survival (P >0.05, log-rank test). The main side effects were sensory neuritis in treatment group and nausea vomiting in control group. There were si gnificant statistically differences in two groups (P< 0.05, Wilcoxon rank sum te st). The other side effects were similar. CONCLUSION: L-OHP +VP-16 +LV +5- FU regimen is effective and well tolerable for advanced gastric carcinoma.

关 键 词：奥沙利铂 治疗 晚期 胃癌 临床观察 L-OHP 醛氢叶酸 5-氟尿嘧啶 足叶乙甙 

分 类 号：R735.2[医药卫生—肿瘤] R979.1[医药卫生—临床医学]