重组人血管内皮抑素联合ＦＯＬＦＯＸ４方案治疗晚期大肠癌的临床观察

目的　评价重组人血管内皮抑素（恩度）联合ＦＯＬＦＯＸ４方案治疗晚期大肠癌的有效性和安全性。方法 经病理组织学检查确诊的晚期大肠癌患者１８例接受恩度联合ＦＯＬＦＯＸ４方案治疗。恩度１５ｍｇ加生理盐水５００ｍｌ静脉缓慢滴注,ｄ１ ～ｄ１４,间歇７天,重复给药;ＦＯＬＦＯＸ４方案具体为：奥沙利铂（Ｌ-ＯＨＰ）８５ｍｇ／ｍ２,静脉滴入２ｈ,ｄ１;亚叶酸钙（ＣＦ）２００ｍｇ／ｍ２,静脉滴入２ｈ,氟尿嘧啶（５-ＦＵ）４００ｍｇ／ｍ２静脉推注后予以６００ｍｇ／ｍ２持续静脉滴入２２ｈ,ｄ１～ｄ２。每２周重复,２８天为１周期;３～４周期后评价疗效。结果　１８例患者均如期完成治疗,可评价客观疗效和安全性。获ＰＲ１１例,ＳＤ３例,ＰＤ４例,客观有效率为６１.１％（１１／１８）,疾病控制率为７７.８％（１４／１８）。主要毒副反应为骨髓抑制、消化道反应和周围神经毒性,无４级毒副反应,无心律失常及出血发生。结论　恩度联合ＦＯＬＦＯＸ４方案治疗晚期大肠癌具有协同作用,疗效好,毒性低,安全性好,值得临床进一步观察。     

奥沙利铂累积剂量与蓄积性神经毒性的相关分析

目的　观察奥沙利铂联合氟尿嘧啶和亚叶酸钙（ＦＯＬＦＯＸ４）方案治疗胃肠道恶性肿瘤的不良反应,探讨奥沙利铂神经毒性反应的发生与累积剂量的关系。方法　１１４例胃肠道恶性肿瘤患者应用ＦＯＬＦＯＸ４方案治疗,具体为：奥沙利铂８５ｍｇ／ｍ^２,静滴２ｈ,ｄ_１;亚叶酸钙２００ｍｇ／ｍ^２,静滴２ｈ,注射后立即静脉推注氟尿嘧啶４００ｍｇ／ｍ^２,后予氟尿嘧啶６００ｍｇ／ｍ^２,持续静滴２２ｈ,ｄ_１、ｄ_２,２周为１周期。挽救化疗患者每２个周期评价疗效,至疾病进展。辅助化疗持续６个月,观察不良反应。结果　１１４例患者的神经毒性反应、恶心呕吐及白细胞减少发生率较高,但均较轻微,３～４级不良反应较为少见,其中恶心呕吐发生率为７.９％,白细胞减少１４.０％,血小板减少３.５％以及腹泻３.５％。奥沙利铂累积剂量在１５０～４２０ｍｇ／ｍ^２、４５０～８００ｍｇ／ｍ^２和８２０～９９６ｍｇ／ｍ^２时,神经毒性反应的发生率分别为４３.８％、８９.７％和１００.０％,５例累积剂量≥１００８ｍｇ／ｍ^２患者中有３例出现３级神经毒性反应。结论　ＦＯＬＦＯＸ４方案化疗的不良反应较轻,其中奥沙利铂神经毒性的发生率及严重程度与其累积剂量呈正相关。     

FDM 方案治疗胃肠道恶性肿瘤31例疗效观察

１９９５年１月～１９９８年７月我们采用ＦＤＭ方案治疗晚期胃肠道肿瘤３１例,取得了一定疗效。报告如下。１　临床资料１．１　一般资料　本文共３１例,男１８例,女１３例,中位年龄５２岁（３７～７０岁）。其中胃癌１９例,结肠癌１２例。所有病例均有病理学诊断。体能状况≥６０分（Ｋａｒｎｏｆｓｋｙ评分法）,血常规检查白细胞大于４．０×１０９／Ｌ,血小板大于８０×１０９／Ｌ,心、肝、肾功能正常。１．２　治疗方法　５ＦＵ　３００ｍｇ／ｍ２,静滴,ｄ１～５;ＤＤＰ３０ｍｇ／ｍ２,静滴,ｄ１～４;ＭＭＣ　６ｍｇ／…     

MDLF方案治疗晚期胃癌近期疗效分析

目的 探讨进展期胃癌化疗的有效方案。方法 对２８例晚期胃癌患者进行ＭＤＬＦ方案化疗。具体如下：氨甲喋呤３０ｍｇ（ｍ＾２．ｄ）静滴第一天；甲酰四氢叶酸钙（ＬＶ）３０ｍｇ／ｄ．５－氟脲嘧啶（５－ＦＵ）５００ｍｇ／ｄ静滴第２至第９天；顺铂（ＤＤＰ）６０ｍｇ／（ｍ＾２．ｄ）静滴第２天，第９天。以上治疗，每四周重复，使用２周期为一疗程。结果 完全缓解（ＣＲ）４例（１４．３％），部分缓解（ＰＲ）１５例（５３．     

替吉奥联合顺铂与替吉奥联合奥沙利铂一线治疗晚期胃癌的比较研究

目的　比较替吉奥（Ｓ １）联合顺铂（ＤＤＰ）与Ｓ １联合奥沙利铂（Ｌ ＯＨＰ）一线治疗晚期胃癌的疗效和安全性。方法　回顾性分析２００７年１月至２０１０年１０月收治的５１例晚期胃癌患者,其中Ｓ-１＋ＤＤＰ组２４例,具体为：Ｓ-１４０ｍｇ／^ｍ２口服,每天２次,第１～２１天;ＤＤＰ２０ｍｇ／ｍ２静滴,第１～４天,４周为１周期。Ｓ-１＋Ｌ ＯＨＰ组２７例,具体为：Ｓ-１４０ｍｇ／ｍ２口服,每天２次,第１～１４天;Ｌ-ＯＨＰ１３０ｍｇ／ｍ^２静滴３ｈ,第１天,３周为１周期。结果　５１例患者均可评价毒副反应,４９例可评价近期疗效,４６例可评价远期疗效。Ｓ-１＋ＤＤＰ组和Ｓ-１＋L-ＯＨＰ组的有效率分别为２７.２％和４４.４％（Ｐ＝０.１４４）,临床受益率分别为５９.１％和７０.３％（Ｐ＝０.２２１）,中位肿瘤进展时间分别为４.６个月和９.０个月（Ｐ＝０.０４８）,中位总生存时间分别为１０.０个月和１１.０个月（Ｐ＝０.１３６）。Ｓ-１＋ＤＤＰ组的白细胞减少、贫血、血小板减少、恶心、呕吐、疲乏的发生率均较Ｓ-１＋L-ＯＨＰ组多见,但差异无统计学意义;Ｓ-１＋ＤＤＰ组的发热及感染、３～４级中性粒细胞减少的发生率明显高于Ｓ-１＋Ｌ-ＯＨＰ组（Ｐ＜０.０５）,Ｓ-１＋Ｌ-ＯＨＰ组的神经毒性发生率高于Ｓ-１＋ＤＤＰ组（Ｐ＜０-０５）。结论　Ｓ-１＋Ｌ-ＯＨＰ方案一线治疗晚期胃癌较Ｓ-１＋ＤＤＰ方案的中位肿瘤进展时间延长以及严重中性粒细胞减少的发生率显著降低,值得临床进一步研究。     

复方肠泰联合ＦＯＬＦＯＸ４方案治疗大肠癌的临床观察

目的　观察中药复方肠泰联合ＦＯＬＦＯＸ４方案治疗大肠癌根治术后患者的疗效及毒副反应。方法　将３０例符合入选标准的大肠癌根治术后患者分为治疗组和对照组。对照组仅应用ＦＯＬＦＯＸ４方案全身化疗,治疗组在化疗同时服用复方肠泰水煎剂。ＦＯＬＦＯＸ４方案：奥沙利铂（ＯＸＡ）８５ｍｇ／ｍ２静滴２ｈ,第１、２天;亚叶酸钙（ＣＦ）２００ｍｇ／ｍ２ 静滴２ｈ,第１、２天;氟尿嘧啶（５-ＦＵ）４００ｍｇ／ｍ２静脉推注,第１、２天,６００ｍｇ／ｍ２持续静滴２２ｈ,第１、２天。复方肠泰每日１剂,早晚各１次水煎服。１４天为１周期。２个周期结束后评价疗效及毒副反应。结果　３０例患者全部完成治疗。经中医证候评定,治疗组和对照组的显效＋有效率分别为８６６％和５３３％（Ｐ＜０.０１）;治疗组治疗前后Ｋａｒｎｏｆｓｋｙ评分未见统计学差异,对照组则降低（Ｐ＜０.０１）;治疗组治疗后较治疗前ＱＯＬ评分提高（Ｐ＜０.０５）,对照组未见明显改变;治疗组治疗后较治疗前ＣＤ３＋、ＣＤ４＋升高（Ｐ＜０.０５）,对照组未见明显改变。治疗组的白细胞减少发生率低于对照组（Ｐ＜０.０５）,两组血小板减少、消化道反应、肝肾功能毒性及神经毒性无显著差异。结论　中药复方肠泰联合ＦＯＬＦＯＸ４方案治疗大肠癌能够有效提高患者体力状况,改善中医证候、生活质量及免疫状态,降低白细胞减少发生率,起到减毒增效作用。     

ELF方案治疗中晚期胃癌的疗效观察

目的 应用ＥＬＦ方案治疗２３例中晚期胃癌,并与ＭＦ方案比较,观察其疗效。方法 ＥＬＦ方案：ＶＰ－１６６０ｍｇ／ｍ２ｉｖ ｇｔｔ ｄ１－５;ＣＦ６０ｍｇ／ｍ＾２ｉｖ ｇｔｔ ｄ１－５;５－Ｆｕ５０ｍｇ／ｍ＾２ ｉｖ ｇｔｔ ｄ１－５。ＣＦ在５－Ｆｕ前静滴,２小时滴定。ＭＦ方案;ＭＭＣ ８ｍｇ／ｍ＾２ｉｖ ｄ１;５－Ｆｕ５０ｍｇ／ｍ＾２ｉｖ ｇｔｔ ｄ１－５。两组均每４周为１周期,共完成２个周期,化疗     

卡培他滨联合奥沙利铂与替吉奥联合奥沙利铂治疗进展期胃癌的对比研究

目的　比较卡培他滨与替吉奥（Ｓ-１）分别联合奥沙利铂（Ｌ-ＯＨＰ）治疗进展期胃癌的有效性和安全性。方法 ９４例进展期胃癌患者分为两组,Ａ组（ＸＥＬＯＸ方案）５４例,具体为：Ｌ-ＯＨＰ１３０ｍｇ／ｍ２静滴２ｈ,ｄ１;卡培他滨１０００ｍｇ／ｍ２ｂｉｄ,ｄ１～ｄ１４,３周为１周期;Ｂ组（Ｌ-ＯＨＰ＋Ｓ-１）４０例,具体为：Ｌ-ＯＨＰ１３０ｍｇ／ｍ２静滴２ｈ,ｄ１;Ｓ-１４０ｍｇ／ｍ２分早晚２次餐后服用,ｄ１～ｄ１４,３周为１周期。２个周期评价疗效及毒性。治疗前后分别进行血常规、肝肾功能、胸腹部ＣＴ扫描及胃镜等检查,观察肿瘤病灶大小变化,记录临床症状变化和化疗毒副反应,随访两组的疾病进展时间和生存期。结果　９４例均可评价疗效,Ａ、Ｂ两组的有效率分别为４６.４％和５１.８％,疾病控制率为７２.８％和７９.４％,中位疾病进展时间为６.６个月和６.８个月,中位生存时间为１３.５个月和１４.０个月,上述两组差异均无统计学意义（Ｐ＞０.０５）。两组毒副反应主要包括血液学毒性、肝肾功能异常、恶心呕吐、腹泻、末梢神经毒性和手足综合征等,以１～２级为主,均可耐受。结论　卡培他滨联合Ｌ-ＯＨＰ与Ｓ-１联合Ｌ-ＯＨＰ治疗进展期胃癌的疗效相当,不良反应均可耐受。     

ＦＯＬＦＯＸ６方案联合腹部内生场热疗治疗晚期大肠癌的临床研究

目的　评价ＦＯＬＦＯＸ６方案联合腹部内生场热疗治疗晚期大肠癌的疗效和不良反应。方法　对照组３９例采用ＦＯＬＦＯＸ６方案：奥沙利铂１００ｍｇ／ｍ２静滴２小时,第１天;亚叶酸钙（ＣＦ）２００ｍｇ／ｍ２静滴２小时,第１天;氟尿嘧啶（５-ＦＵ）４００ｍｇ／ｍ２静推,第１天,然后总量２４００ｍｇ／ｍ２持续静滴４６小时;每２周重复１次。试验组３９例采用ＦＯＬＦＯＸ６方案化疗的同时（剂量和方法同对照组）,每周期第１天（５-ＦＵ静滴后１小时）、第８天分别进行腹部内生场热疗１小时。４周期治疗结束后评价疗效和毒副反应。结果　试验组有效率（ＣＲ＋ＰＲ）为５６４１％,中位肿瘤进展时间（ＴＴＰ）为９.５个月;对照组有效率为４１.０３％,中位ＴＴＰ为８.６个月,试验组略优于对照组,但两组差异无统计学意义（Ｐ值分别为０.１７４和０.８１２）。试验组神经系统毒性较对照组明显减轻,尤其是肢端感觉异常及面部感觉异常,两组差异有统计学意义（Ｐ值分别为０.０２３和０.０３９）。结论　ＦＯＬＦＯＸ６方案联合腹部内生场热疗治疗晚期大肠癌的疗效好,毒副作用少。     

CCAV与EP方案交替治疗小细胞肺癌疗效观察

目的：探讨ＣＣＡＶ与ＥＰ方案交替治疗小细胞肺癌的临床疗效。方法：４２例小细胞肺癌,局限期１２例,广泛期３０例。ＣＣＡＶ方案：ＣＣＮＵ１００ｍｇ／ｍ＾２,ｄ１,口服;ＶＣＲ１．４ｍｇ／ｍ＾２,ｄ２、９,静脉推注,;ＣＴＸ６００ｍｇ／ｍ＾２,ｄ３、１０,静脉推注;ＡＤＭ４０ｍｇ／ｍ＾２,ｄ３,静脉推注。ＥＰ方案;ＶＰ－１６０１００ｍｋｇ／ｍ＾２,ｄ１－５,静滴;ＤＤＰ２５ｍｇ／ｍ＾２,ｄ１－３静滴。两     

FOLFOX4与FLP方案在食管胃结合部癌辅助化疗中的疗效比较

目的:回顾性分析辅助化疗FOLFOX4方案与FLP方案治疗食管胃结合部癌根治术后患者的疗效和不良反应。方法:回顾性分析2007年3月-2009年10月共123例接受FOLFOX4方案(67例)或FLP方案(56例)辅助化疗的食管胃结合部癌根治术后患者。主要评价指标为无病生存期(disease-free survival,DFS)、总生存期(overall survival,OS)和不良反应。同时,对两组患者的疗效进行分层分析。结果:FOLFOX4方案组和FLP方案组的中位DFS分别为35.9和16.8个月(P=0.008),中位OS分别为41.3和25.6个月(P=0.013)。分层分析显示,男性、45～65岁、腺癌以及Ⅱ期或ⅢA期患者接受FOLFOX4方案术后辅助化疗较FLP方案更具生存优势。FOLFOX4和FLP方案均耐受良好,血液学不良反应发生率无明显差异。FOLFOX4方案组非血液学不良反应主要为外周神经毒性,FLP方案组主要为消化系统反应。结论:与FLP方案相比,FOLFOX4方案辅助化疗可明显延长食管胃结合部癌术后患者的DFS和OS,且不良反应可耐受。     

FOLFOX4方案和ECF方案治疗老年晚期胃癌的疗效比较

目的:比较FOLFOX4方案和ECF方案治疗老年晚期胃癌的疗效及不良反应.方法:将56例经病理确诊的老年晚期胃癌患者随机分为两组.A组29例,采用FOLFOX4方案化疗:草酸铂75mg/m2 ,静脉滴注2h,d1;亚叶酸钙200mg/m2 ,静脉滴注2h,d1-2;氟尿嘧啶400mg/m2 ,静脉推注,d1、d2 ,氟尿嘧啶600mg/m2 ,持续静脉泵输注22h,d1-2.每2周为1周期.B组27例,采用ECF方案化疗:表柔比星45mg/m2 ,静脉推注,d1;氟尿嘧啶675mg/m2 ,持续静脉泵输注120h;顺铂20mg/m2 ,静脉滴注,d1-3 .每3周为1周期.对两组的近期疗效、疾病进展时间、总生存期、生活质量改善情况、不良反应进行比较.结果:A组和B组的有效率分别为41.4% (12/29)和44.4% (12/27),无显著性差异(P=0.8168).A组和B组的中位疾病进展时间4.6月(1-15月 ),4.8个月(1-14月)(P= 0.8899);中位生存时间7月(2-16月),6.9月(2-16月)(P=0.2905).A组和B 组的生活质量改善为65.5% (19/29)和37.0% (10/27)有显著性差异(P=0.0331);两组主要不良反应白细胞减少、腹泻、口腔炎、神经毒性、脱发、心脏毒性等指标的差异具有显著性(P＜0.05).结论:FOLFOX4方案和ECF方案治疗老年晚期胃癌近期疗效较好,在生活质量改善以及不良反应方面,FOLFOX4方案优于ECF方案,具有更好的耐受性.     

A simplified regimen of weekly high dose 5-fluorouracil and leucovorin as a 24-hour infusion in patients with advanced colorectal carcinoma

BACKGROUND: Reports of in vitro experiments in colorectal carcinoma cells suggest that prolonged cellular exposure to 5-fluorouracil (5-FU) combined with relatively low concentrations of leucovorin (LV) provides optimal enhancement of 5-FU efficacy. In this study, a simplified regimen of weekly 24-hour infusion of high dose 5-FU combined with a relatively low dose of LV was used to treat patients with advanced colorectal carcinoma. METHODS: Thirty-six patients with advanced colorectal carcinoma received 5-FU, 2600 mg/m2, admixed with LV, 100 mg/m2, in a portable infusion pump administered intravenously over a 24-hour period. High dose 5-FU/LV was delivered once a week for 5 consecutive weeks followed by a 1-week recovery period. All patients were assessable for toxicity and response. RESULTS: Two complete responses and 15 partial responses were observed (response rate of 47.2%; 95% confidence interval, 30.1-64.4%). The median response duration was 9.6 months. The median survival and time to progression were 11.9 months and 7.1 months, respectively. The toxicity was mild and acceptable. The major dose-limiting factors were hand-foot syndrome and fatigue. CONCLUSIONS: This simplified regimen of weekly 24-hour continuous infusion of high dose 5-FU/LV is an effective regimen in the treatment of patients with advanced colorectal carcinoma. Further study of the pharmacokinetics of combination therapy with 5-FU and LV as used in this regimen and its correlation with response and toxicity is warranted.     

SOX方案与EOF方案一线治疗进展期胃癌的临床对比研究

背景与目的:目前化疗仍是治疗进展期胃癌的主要方法之一。ECF(表柔比星+顺铂+氟尿嘧啶)方案疗效已被Ⅲ期临床试验所验证。有研究显示奥沙利铂治疗胃癌的疗效及安全性优于顺铂。本研究旨在观察SOX(替吉奥+奥沙利铂)方案与EOF(表柔比星+奥沙利铂+氟尿嘧啶)方案一线治疗进展期胃癌的疗效与不良反应。方法:将53例经病理学诊断的进展期胃癌患者,随机分为SOX组与EOF组。SOX组(n=27)口服替吉奥胶囊40 mg/m2,每天2次,第1～14天;奥沙利铂130 mg/m2(静脉滴注2 h),第1天;21 d为1个周期,至少完成2个周期。EOF组(n=26)给予表柔比星50 mg/m2,第1天;奥沙利铂130 mg/m2,第1天;氟尿嘧啶750 mg/m2,第1～5天;21 d为1个周期。至少完成2个周期。观察两组的疗效和不良反应。结果:SOX组和EOF组有效率分别为51.9%和50%,差异无统计学意义(χ2=0.018,P=0.894);SOX组KPS评分改善率较EOF组明显提高(74.1%vs 38.5%,P=0.040)。SOX组和EOF组的中位疾病进展时间(time to progression,TTP)分别为173 d和154 d(χ2=0.010,P=0.922),中位生存时间(mean survival time,MST)分别为337 d和315 d(χ2=0.458,P=0.498)。SOX组Ⅲ～Ⅳ度骨髓抑制、恶心呕吐、脱发发生率均明显低于EOF组,差异有统计学意义(P<0.05)。结论:SOX方案和EOF方案一线治疗进展期胃癌的近期疗效相同,但SOX方案不良反应发生率较低,其远期疗效、TTP、生存期等资料还需扩大样本进一步验证。     

Combination of folinic acid, 5-fluorouracil bolus and infusion, and cisplatin (LV5FU2-P regimen) in patients with advanced gastric or gastroesophageal junction carcinoma.

BACKGROUND: Combination chemotherapy with continuous 5-fluorouracil (5-FU) and cisplatin in a monthly regimen is one of the standard treatments for advanced gastric carcinoma. This study evaluated the new LV5FU2-P regimen, designed to improve efficacy and tolerance of the 5-FU plus cisplatin combination. PATIENTS AND METHODS: Forty-three patients with advanced or metastatic gastroesophageal junction or gastric carcinoma were prospectively included in the study. They were treated every 14 days with cisplatin 50 mg/m(2) on day 2 plus folinic acid 200 mg/m(2)/day as a 2-h intravenous (i.v.) infusion on days 1 and 2, plus bolus 5-FU 400 mg/m(2)/day on days 1 and 2, plus continuous 5-FU 600 mg/m(2)/day as a 22-h i.v. infusion on days 1 and 2. Ten patients received a simplified regimen (folinic acid 40 mg/m(2) day 1 + bolus 5-FU 400 mg/m(2) day 1 + continuous 5-FU 2400 mg/m(2) on days 1 and 2 with cisplatin 50 mg/m(2) on day 2). RESULTS: All the patients were assessable for response and 42 for toxicity. One patient achieved a complete response and 15 a partial response, for an overall response rate of 37.2% [95% confidence interval (CI) 22.1% to 52.3%]. The median progression-free survival was 7.2 months (95% CI 5.4-10.9) and the overall survival was 13.3 months (95% CI 10.1-16.4). There were no treatment-related deaths. Hematological and gastrointestinal toxicities were the most common severe toxicities. CONCLUSIONS: LV5FU2-P is an active and well tolerated regimen in the treatment of advanced gastroesophageal junction or gastric carcinomas. It warrants evaluation comparatively with other active regimens.     

氟尿嘧啶/亚叶酸联合奥沙利铂或紫杉醇治疗晚期胃癌--临床随机对比研究

目的：比较氟尿嘧啶／亚叶酸(5-FU／FA)联合奥沙利铂与5-FU／FA联合紫杉醇治疗晚期胃癌的近期疗效和毒副反应。方法：40例进展期胃癌患者随机分成两组，5-FU／FA联合奥沙利铂组(A组)20例，70．0％为复治患者，5-FU／FA联合紫杉醇组(B组)20例，55．0％为复治患者，转移部位包括肝、淋巴结、腹腔、腹壁等。结果：两组患者各有20例可评价疗效，A组CR2例，PR7例，有效率(CR PR)45．0％，B组PR9例，有效率45．0％。A组有20例评价毒性反应，主要为骨髓抑制、外周神经毒性、消化道反应、肝功能损害；B组有20例可评价毒性反应，主要为骨髓抑制、肝功能损害。结论：5-FU／FA联合奥沙利铂与联合紫杉醇治疗晚期胃癌疗效相当．毒性反应可耐受。两者相比，联合奥沙利铂具有用药方便，严重的毒副反应少等优点。     

Phase II trial of epirubicin, cisplatin, oral uracil and tegafur, and leucovorin in patients with advanced gastric carcinoma.

BACKGROUND: The results of chemotherapy for patients with gastric carcinoma generally have been modest, although regimens developed more recently have produced higher response rates. One such regimen is epirubicin, cisplatin, and protracted infusion of 5-fluorouracil (ECF). The advantage of a long-term oral administration of uracil and tegafur (UFT) is that this treatment may be used to mimic the protracted infusion of 5-fluorouracil (5-FU). In addition, UFT treatment combined with leucovorin had a favorable activity and tolerable toxicity in patients with advanced gastric carcinoma. Instead of the inconvenience of an infusion pump and intravenous catheter for the protracted infusion of 5-FU, the authors administered UFT plus leucovorin in an ECF regimen for the treatment of patients with advanced gastric carcinoma. METHODS: Fifty-two patients with advanced gastric carcinoma received epirubicin, cisplatin, and oral UFT plus leucovorin. Epirubicin 50 mg/m(2) and cisplatin 60 mg/m(2) were administered on Day 1 by intravenous injection. Tegafur and uracil 360 mg/m(2)/day orally was administered in conjunction with leucovorin administered at a fixed dose of 45 mg/day orally in divided daily doses for 21 days followed by a 7-day rest period. These courses were repeated every 4 weeks. The median age of the patients was 59 years with a median World Health Organization performance status of 1. Patients received a median of five courses of treatment (range, 1-10). RESULTS: Among the 47 patients evaluated, three patients achieved complete response, and 24 patients had partial responses, for an overall response rate of 57.5% (95% confidence interval, 71.5-43.3%). Stable disease was reported in 11 patients (23.4%), and another 9 patients (19.1%) showed disease progression. The median duration of survival was 15 months (range, 2-33+). The main toxicity was nausea/vomiting and neutropenia. Significant toxicity (modified National Cancer Institute common toxicity Grade 3 or 4) included neutropenia in 22 patients (42%), nausea in 14(27%), vomiting in 9 (18%), oral mucositis in 3 (6%), and diarrhea in 3 (6%) patients. CONCLUSIONS: The authors conclude that epirubicin, cisplatin, and oral UFT plus leucovorin, a convenient regimen, has a significant activity and tolerable toxicities in patients with gastric carcinoma.     

Chemotherapy for colorectal carcinoma

5-fluorouracil (5-FU) plus leucovorin (LV) therapy is the most widely used regimen with a high evidence as the first-line treatment for advanced colorectal cancer (CRC), as well as CPT-11 as the second-line. Recently, it is reported in several randomized prospective studies that convenient oral combination of UFT and LV has equal efficacy and less adverse effect. Intrahepatic arterial infusion (IHA) therapy shows high response rate in the treatment of liver metastasis. Survival benefit of IHA has to be disclosed by further clinical trials. Prospective studies showed that 6 months' administration of 5-FU and LV after curative resection of Dukes' C CRC contributes to a patients' better survival.     

FOLFOX4方案和ECF方案治疗老年晚期胃癌的疗效比较

目的：比较FOLFOX4方案和ECF方案治疗老年晚期胃癌的疗效及不良反应。方法：将56例经病理确诊的老年晚期胃癌患者随机分为两组。A组29例,采用FOLFOX4方案化疗：草酸铂75mg/m^2,静脉滴注2h,d1;亚叶酸钙200rag／m^2,静脉滴注2h,d1-2;氟尿嘧啶400mg/m^2,静脉推注,d1、d2,氟尿嘧啶600mg／m^2,持续静脉泵输注22h,d1-2。每2周为1周期。B组27例,采用ECF方案化疗：表柔比星45mg／m^2,静脉推注,d1;氟尿嘧啶675mg／m^2,持续静脉泵输注120h;顺铂20mg/m^2,静脉滴注,d1-3。每3周为1周期。对两组的近期疗效、疾病进展时间、总生存期、生活质量改善情况、不良反应进行比较。结果：A组和B组的有效率分别为41．4％（12／29）和44．4％（12／27）,无显著性差异（P=0．8168）。A组和B组的中位疾病进展时间4．6月（1—15月）,4．8个月（1—14月）（P=0．8899）;中位生存时间7月（2—16月）,6．9月（2—16月）（P=0．2905）。A组和B组的生活质量改善为65．5％（19／29）和37．0％（10／27）有显著性差异（P=0．0331）;两组主要不良反应白细胞减少、腹泻、口腔炎、神经毒性、脱发、心脏毒性等指标的差异具有显著性（P〈0．05）。结论：FOLFOX4方案和ECF方案治疗老年晚期胃癌近期疗效较好,在生活质量改善以及不良反应方面,FOL-FOX4方案优于ECF方案,具有更好的耐受性。     

FOLFIRI regimen for metastatic or recurrent colorectal cancer

Irinotecan (CPT-11) plus 5-fluorouracil (5-FU) and Leucovorin (LV) became the standard first-line chemotherapy for colorectal cancer in the U.S. and Europe in 2000, largely owing to the results of controlled randomized phase III trials of 5-FU/LV with or without CPT-11. One of the regimens for CPT-11 plus infusional 5-FU/LV therapy is the FOLFIRI regimen. This regimen consists of CPT-11 180 mg/m(2) as a 90-min infusion on day 1 and l-LV 200 mg/m(2) as a 2-h infusion during CPT-11, immediately followed by a bolus dose of 5-FU 400 mg/m(2) and a 46-h continuous infusion of 2,400 mg/m(2) every 2 weeks. FOLFIRI, as well as oxaliplatin/5-FU/LV therapy (FOLFOX), is an internationally accepted standard chemotherapy for metastatic colorectal cancer. Safe use of this effective regimen requires adequate supportive therapy in Japan, as well as in Western countries.