亚叶酸钙/氟尿嘧啶、顺铂3种方案治疗晚期胃肠道腺癌

目的 :观察两种剂量的亚叶酸钙 (CF 2 0mg/m2 ,2 0 0mg/m2 )、两种给药方法的氟尿嘧啶 (5 FU ,持续灌注和每天静滴 2小时 )与顺铂 (DDP 2 0mg/m2 )组成 3种方案分别治疗晚期胃肠道腺癌的临床疗效及不良反应。方法 :将 1999年 1月～ 2 0 0 0年 11月住院治疗的晚期胃肠道腺癌 36例患者随机分为A、B两组 ,回顾性分析 1997年 4月～ 1998年 12月住院治疗的 2 9例同种患者作为对照组C组。A组 :CF 2 0 0mg/m2 ,静滴 2小时 ,每天 1次 ,连用 5天 ;5 FU 3g/m2 ,持续静脉灌注 5天 (加入Baxter泵内 ) ,DDP 2 0mg/m2 ,静滴 2小时 ,每天 1次 ,连用 5天。B组 :CF 2 0mg/m2 ,用法同A组 ;5 FU、DDP剂量与方法同A组。C组 :CF 2 0 0mg/m2 ,用法同A、B组 ;5 FU 6 0 0mg/ (m2 ·d) ,用法同CF ;DDP方法同A、B组。以上方案每 3周为 1周期 ,连续 3个周期后评价疗效及不良反应。结果 :A组 (n =2 0 )胃癌 8例、大肠癌 12例 ,有效率 (CR +PR)分别为 5 0 %(4 / 8)、41.7%(5 / 12 ) ;B组 (n =16 )胃癌7例、大肠癌 9例 ,有效率 (CR +PR)分别为 42 .9%(3/ 7)、44 .4%(4 / 9) ;C组 (n =2 9)胃癌 14例、大肠癌 15例 ,有效率 (CR +PR)分别为 35 .7%(5 / 14)、40 %(6 / 15 )。毒副反应 :A、B两组血液毒性、胃肠道反应及肾、膀胱毒性相近

Three different regimens of CF/5-FU,DDP in treatment of patients with advanced gastrointestinal adenocarcinoma

Purpose:To study the efficacies and adverse effects of three different regimens in treatment of patients with gastrointestinal adenocarcinoma, which consisted of two doses of CF(20 mg/m 2, 200 mg/m 2) and two methods of administration of 5-Fu (continuous intravenous infusion and two hours per day intravenously) and DDP 20 mg/m 2. Methods:We selected 36 cases with GI adenocarcinoma and randomizedly divided them into A and B groups, who were hospitalized from January 1999 to November 2000. At the same time, 29 cases hospitalized from April 1997 to December 1998 with the same disease were designated as C group (control) . A group: CF 200 mg/(m 2.d) for 5 days, 2 hours intravenously ; 5-Fu 3 g/m 2 , continuous intravenous infusion during 5 days; DDP 20 mg/(m 2.d) for 5 days, 2 hours IV. B group: CF 20mg/(m 2.d) for 5 days, 2 hours, IV.; the dosage and usage of 5-Fu and DDP as A group. C group: CF 200 mg/m 2, usage as A, B groups; 5-Fu 600 mg/(m 2.d) for 5 days, 2 hours; dosage and usage of DDP as A, B groups. One cycle of these regimens consisted of three weeks and they were evaluated after three cycles. Results:There were 8 cases of gastral cancer and 12 of rectal cancer in A group whose response rates were 50% and 41.7% respectively. B group had 7 cases of gastric cancer and 9 cases of rectal cancer, their response rates were 42.9% and 44.4%. C group consisted of 14 cases of gastric cancer and 15 cases of rectal cancer, whose response rates were 35.7%and 40%, respectively. Adverse effects included hematological, renal and bladder and gastrointestinal toxicity. A group was similar to B group. C group had more renal and bladder toxicities(27.5%) and incidence of phlebitis was 34.5%. Conclusions:Combination regimen of low dose of CF, continuous intravenous infusion of 5-Fu and DDP is of better efficacy, tolerance and relative economy, especially suitable for to the elderly patients.