奥沙利铂联合羟基喜树碱、亚叶酸钙/5-氟尿嘧啶治疗晚期胃癌

目的 :观察奥沙利铂 (L OHP)联合羟基喜树碱 (HCPT)、亚叶酸钙 (CF)和 5 氟尿嘧啶 (5 FU)组成的HLFO方案治疗晚期胃癌的临床疗效和毒副反应 ,并与后三种药物与顺铂 (PDD)组成的HLFP方案进行比较。方法 :采用随机分组的方法将 4 2例晚期胃癌患者分为L OHP +HCPT +CF +5 FU方案组 (治疗组 ) 2 2例与HCPT +CF +5 FU +DDP方案组 (对照组 ) 2 0例 ,观察两组的临床疗效和患者的耐受性。结果 :治疗组 2 2例有效率 5 9 1% (13 2 2 ) ,对照组 2 0例有效率 4 5 % (9 2 0 ) ,治疗组有效率高于对照组 ,但两组差异无统计学意义 (P >0 0 5 )。治疗组KPS评分的改善率为 72 7% ,对照组KPS评分的改善率为 4 0 % ,两组差异有统计学意义 (P <0 0 5 )。治疗组的中位生存期及 1年生存率均优于对照组 ,但生存期比较差异无统计学意义 (P >0 0 5 )。治疗组的周围神经毒性较对照组高 ,差异有统计学意义 (P <0 0 5 ) ;对照组的恶心呕吐反应较治疗组高 ,差异有统计学意义 ;其余不良反应均相似。结论 :与HLFP方案相比 ,HLFO方案能明显改善晚期胃癌患者的生活质量 ,消化道毒副反应较轻 ,值得进一步扩大样本量进行临床随机对照研究

Treatment of Advanced Gastric Cancer with the Regimen of Oxaliplatin,Hydroxycamptothecine,Leucovorin and Fluorouracil

Objective:This study was designed to investigate the clinical curative effects and tolerance of the patients with advanced gastric cancer of treatment with the regimen of oxaliplatin(L-OHP), hydroxycamptothecine (HCPT), leucovorin/5-fluorouracil (CF/5-Fu). We compared this treatment with the regimen of hydroxycamtothecine, leucovorin, fluorouracil and cisplatin. Methods:In a randomized manner, 42 patients with advanced gastric cancer were divided into treatment group (HLFO:HCPT+CF+5-FU+L-OHP) and control group (HLFP:HCPT+CF+5-FU+DDP). Among these patients, 23 were male and 19 were female. The median age was 55 years old. Karnofsky performance status (KPS) scale was more than 60. We compared the clinical curative effects and tolerance between these two groups.Results: The overall responses rate for the treatment group and control group were 59 1%(13/22) and 45%(9/20), respectively. The overall responses to the treatment group were higher than that of the control group, but there were no statistically significant difference between the two group (P>0 05). The improvement rate of KPS score for the treatment group and control group were 72 7%(16/22) and 40 0%(8/20), respectively. Obviously, the improvement of life quality to the treatment group were higher than that of the control group (P<0 05). The median survival and 1-year survival rate seen in the treatment group were better than that in the control group, but there were no statistically significant difference between the two group (P>0 05). The peripheral neuritis were more pronounced in the treatment group (P<0 05); Nausea and vomiting were more pronounced in the control group (P<0 05); Other toxcities were similar. Conclusion:Compared with HLFP regimen, HLFO regimen obviously improve life quality of the patients with advanced gastric cancer resulting in less digestive tract toxicities, Although whether its efficacy is better should be confirmed by well-controlled randomized clinical trials with more patients.