FOLFOX4方案治疗晚期胃癌的临床观察

目的:观察FOLFOX4方案治疗国人晚期胃癌的近期疗效和毒副反应。方法:28例晚期胃癌患者,先给予FOLFOX4方案,即:奥沙利铂(L-OHP)85mg/m2静脉点滴2h,d1;亚叶酸钙(CF)200mg/m2静脉点滴,2h,d1、d2;随后氟尿嘧啶(5-FU)400mg/m2静脉推注,d1、d2,5-FU600mg/m2微泵持续静脉滴注22h,d1、d2。2周重复。4个周期后以WHO评价标准评价疗效和毒性。结果:全组28例均可评价,其中完全缓解(CR)2例,部分缓解(PR)14例,稳定(SD)7例,进展(PD)5例,总有效率(CR PR)57.1%。中位肿瘤进展时间(TTP)5.5个月,中位生存时间(MST)为9个月。毒副反应主要是骨髓抑制,白细胞降低发生率达82.1%,其次为胃肠道反应,恶心呕吐发生率78.6%,口腔粘膜炎为21.4%,腹泻35.7%,无Ⅲ/Ⅳ度胃肠道反应;周围神经毒性发生率为46.4%。结论:FOLFOX4方案治疗国人晚期胃癌的近期疗效较好,毒副反应可以耐受,值得进一步研究应用。

Clinical study of advanced gastric cancer patients treated with leucovorin, 5-fluorouracil and oxaliplatin (FOLFOX4) chemotherapy

Objective:To evaluate the efficacy and adverse effects of oxaliplatin combined with 5-fiuorouracil(5-FU)and calcium folinate in the treatment of patients with advanced gastric cancer.Methods:Twenty eight patients with advanced gastric cancer received chemotherapy of regimen L-OHP 85mg/m2 2 hours d1,CF 200mg/m2 2 hours d1,d2,followed by 5-FU 400mg/m2 iv and 600mg/m2 22 hours civ d1,d2,two weeks as one cycle.Efficacy was evaluated after 4 cycles.Results:Two patients achieved complete response(CR),14 patients partial response(PR),7 patients stable disease(SD),5 patients progression disease(PD).Overall response rate was 57.1%.The major toxicity included nausea,vomiting,leucopenia and neurosensory.Conclusion:This study shows that the regimen of FOLFOX4 is effective and tolerable in advanced gastric cancer.