奥沙利铂联合5-氟脲嘧啶、甲酰四氢叶酸时辰治疗晚期胃肠道癌的临床研究

目的评价奥沙利铂(L-OHP)联合5-氟脲嘧啶(5-Fu)、甲酰四氢叶酸(CF)方案以时辰化疗法治疗晚期胃肠道癌的疗效和毒副反应。方法44例晚期胃肠道癌患者,使用FFL方案时辰化疗法治疗:L-OHP 25 mg/(m2.d),每天给药时间为10∶00-22∶00,持续输注12 h,给药高峰16∶00;5-Fu 600 mg/(m2.d),CF 300 mg/(m2.d),每天给药时间为22∶00-次日10∶00,不同输液通道持续输注12 h,给药高峰4∶00,使用多通道程控时辰输液泵连续给药4 d,14-21 d为1个周期,至少使用2个周期。结果44例患者共完成151个周期化疗,每例患者化疗平均周期数为3.4个周期。33例晚期胃癌患者中,部分缓解(PR)17例,稳定(SD)10例,进展(PD)6例;11例晚期结直肠癌患者中,部分缓解(PR)4例,稳定(SD)4例,进展(PD)3例。所有患者的总有效率为47.7%(21/44)。中位肿瘤进展时间为5个月,中位生存期为8个月。最常见的毒副反应为骨髓抑制、恶心和呕吐、外周神经毒性、黏膜炎、腹泻,但以Ⅰ-II度为主。中位肿瘤进展时间为5个月,中位生存期为8个月。结论FFL方案时辰化疗疗效满意,毒副反应轻,是治疗晚期胃肠道癌安全有效的化疗方案。

Clinical Study of Chrono-chemotherapy with Oxaliplatin,5-fluorouracil and Folinicacid for Advanaed Gastrointestinal Cancer

Objective To evaluate the efficacy and toxicity of chrono-chemotherapy with oxaliplatin(L-OHP),5-fluorouracil(5-Fu) and folinicacid(CF) for advanced gastrointestinal cancer.Methods 44 patients with advanced gastrointestinal cancer received chrono-chemotherapy: L-OHP 25 mg/(m2·d) infused from 10∶00 to 22∶00,with the highest plasma drug level at 16:00;5-Fu 600 mg/(m2·d) and CF 300 mg/(m2·d) infused from 22∶00 to 10∶00the next day,the highest plasma drug level at 4∶00,using a multichannel programmable infusion pump,which was repeated every 2～3 weeks for at least 2 cycles.Results 151 cycles of the chrono-chemotherapy were completed and median cycles of the treatment were 3.4.Among 33 patients with advanced gastric cancer,17 patients achieved partial remissions(PR),10 patients achieved stable diseases(SD) and 6 patients achieved progressive diseases(PD).Among 11 patients with advanced colorectal cancer,4 patients achieved partial remissions(PR),4 patients achieved stable diseases(SD) and 3 patients achieved progressive diseases(PD).All patients had a total response rate of 47.7%(21/44),and the median time of tumor progression(TTP) was 5 months.The median overall survival time was 8 months.The main toxicity includes myelosuppression,nausea/vomiting,end-brush neurotoxicity,mucositis and diarrhea.Most toxicities were grade Ⅰ～Ⅱ.Conclusion Chrono-chemotherapy with oxaliplatin,5-fluororuacil and folinicacid is effective and safe in the treatment of advanced gastrointestinal cancer.