草酸铂联合氟尿嘧啶和醛氢叶酸双周疗法治疗晚期大肠癌46例临床观察

目的：评价草酸铂(L-OHP)联合5-氟尿嘧啶(5-FU)／醛氢叶酸(LV)双周疗法治疗晚期大肠癌的疗效。方法：采用L-OHP联合5-FU/LV双周疗法治疗经病理检查确诊的晚期大肠癌46例，所有患者均有可评价病灶。治疗方案为L-OHP85mg／m^2，静脉滴入2h；LV200mg／m^2，静脉滴入2h；5-FU500mg，静脉推注10min：5-FU3．0g／m^2，静脉持续灌注46h。以上方案每2周重复1次，每2次为1个疗程，所有患者至少接受2个疗程的治疗。结果：46例可评价疗效：CR6例，PR16例．NC18例，PD6例，CR PR为47．8％(22／46)。不良反应主要为周围神经毒性、恶心和呕吐、骨髓抑制和腹泻。结论：L-OHP联合5-FU／LV双周疗法治疗晚期大肠癌患者，疗效好，不良反应轻。     

草酸铂联合氟尿嘧啶和醛氢叶酸双周疗法治疗晚期大肠癌36例

 目的 评价草酸铂（L-OHP）联合5-氟尿嘧啶（5-Fu）／醛氢叶酸（LV）双周疗法治疗晚期大肠癌的疗效。方法 采用L-OHP联合5-Fu／LV双周疗法治疗经病理检查确诊的晚期大肠癌36例，所有患者均有可评价病灶。治疗方案为L-OHP 85 mg／m2，静脉滴注3 h；LV 200 mg／m2，静脉滴注2 h；5-Fu 500 mg，静脉推注10 min；5-Fu 3.0 g／m2，静脉持续灌注46 h。以上方案每2周重复1次，每2次为1个疗程，所有患者至少接受2个疗程的治疗。结果 36例可评价疗效：CR5例，PR14例，NC12例，PD5例，CR+PR为52.8 %（19／36）。毒副反应主要为周围神经毒性、口腔黏膜炎、恶心和呕吐、腹泻和骨髓抑制。结论 L-OHP联合5-Fu／LV双周疗法治疗晚期大肠癌，疗效好，毒副反应轻。     

草酸铂联合醛氢叶酸及5氟尿嘧啶治疗晚期胃癌

对31例晚期胃癌病人采用草酸铂联合大剂量醛氢叶酸及5氟尿嘧啶持续48小时滴注的方案进行治疗，平均2．55个疗程。结果完全缓解3例，部分缓解16例，稳定9例，进展3例。有效率61．29％，且主要的不良反应可以耐受。     

草酸铂和5氟尿嘧啶合用醛氢叶酸治疗晚期大肠癌

大肠癌是最常见的恶性肿瘤之一 ,近年来 ,我国大肠癌发病率呈上升趋势 ,死亡率也不断上升[1] 。晚期大肠癌预后差 ,复发、转移后化疗效果不理想 ,多年来 ,5 Ｆｕ一直是治疗大肠癌的首选药 ,治疗大肠癌的近期有效率约 2 0 % [2 ] 。第三代铂类———草酸铂 (Ｌ -ＯＨＰ)的问世     

羟基喜树碱联合草酸铂、醛氢叶酸、氟尿嘧啶治疗晚期大肠癌32例

[目的]评价羟基喜树碱（HCPT）联合草酸铂（L-OHP）、醛氢叶酸（CF）和氟尿嘧啶（5-Fu）方案治疗晚期大肠癌近期疗效和毒副反应.[方法]32例晚期大肠癌给予L-OHP 100mg/m^2,静脉滴入,2h,d1;HCPT 6mg/m^2,静脉滴入,2h,d1～5;CF 100mg/m^2,静脉滴入,2h,d1～5;5-Fu 500mg/m^2,静脉滴入,6～8 h,d1～5（CF用后）,21天为1个周期.每例治疗2～4个周期后进行疗效和毒副反应评定.[结果]CR 4例（12.5%）,PR 13例（40.6%）,SD 10例（31.3%）,PD 5例（15.6%）.总有效率为53.1%（17/32）.[结论]HCPT联合L-OHP、CF、5-Fu治疗晚期大肠癌有较高的近期疗效,主要毒副作用是白细胞下降和腹泻.     

奥沙利铂和5-氟尿嘧啶/醛氢叶酸双周疗法治疗晚期胃癌

目的评价奥沙利铂和5-氟尿嘧啶／醛氢叶酸双周疗法治疗晚期胃癌的疗效及安全性。方法26例晚期胃癌患者均有可评价的病灶，25例完成下例方案：奥沙利铂85mg／m^2及醛氢叶酸(LV)200mg／m^2(2小时静脉滴注)，随后5-氟尿嘧啶(5-Fu)400mg／m^2(10分钟静注)，5-Fu 600mg／m^2持续静脉输注22h，醛氢叶酸及5-Fu连用两天，每2周重复1次，每2次为1个疗程，所有患者至少接受2个疗程的治疗。结果完全缓解2例，部分缓解12例，总有效率56％(14／25)，中位缓解期3个月。无治疗相关死亡，主要不良反应为轻度的外周神经系统感觉障碍，恶心呕吐，白细胞及血红蛋白降低。结论奥沙利铂和5-氟尿嘧啶／醛氢叶酸双周疗法对晚期胃癌疗效确切，毒副反应轻，拓展了晚期胃癌患者化疗方案的选择。     

小剂量持续应用氟尿嘧啶联合顺铂和醛氢叶酸治疗晚期胃癌疗效观察

观察小剂量氟尿嘧啶联合顺铂和醛氢叶酸治疗晚期胃癌的近期疗效、临床受益率及毒性反应。方法：采用小剂量氟尿嘧啶（350mg／m^2）联合顺铂（10mg／d）和醛氢叶酸（50mg／mz）静脉滴入,治疗晚期胃癌36例。根据患者不良反应尽量采取长程用药,全部患者均接受2～6个周期化疗,每个周期5～20d不等。结果;全组患者有效率（CR＋PR）44．4％,其中CR11．1％,PR33．3％,SD36.1％,PD19．4％。低分化腺癌、管状腺癌、乳头状腺癌、黏液细胞癌有效率分别为22．2％、13．9％、2．8％、0;临床受益率80．6％,食欲好转72．2％,疼痛减轻52．8％,体质量增加30．6％,Kamofsky评分增加〉20分为63．9％。不良反应主要为恶心、呕吐、外周静脉炎、口腔溃疡和白细胞减少,多为Ⅰ～Ⅱ度。结论：小剂量氟尿嘧啶联合顺铂和醛氢叶酸缓慢静脉滴入是治疗晚期胃癌的一种安全有效的化疗方案。     

氟尿嘧啶长疗程辅以醛氢叶酸及顺铂治疗转移性结直肠癌32例

[目的]评价5氟尿嘧啶(5Fu)长疗程静滴并辅以醛氢叶酸(CF)及顺铂(DDP)治疗转移性结直肠癌的临床疗效及其毒性反应.[方法]CF100mg/m2dl～14静脉滴注1h;5Fu350mg/m2dl～14静脉滴注6h～8h;DPP50mgd6,7静脉滴注(水化).28天为1周期,连用2个周期.[结果]肝转移灶1～2个,<2.5cm者12例,CR3例,PR4例;转移灶>3.0cm或多发转移灶者9例,PR3例;腹膜后淋巴结转移者7例,CR2例,PR2例;肺转移者2例,NC1例,PD1例;脑转移者2例,无效.32例中14例有效,有效率(CR+PR)为43.7%.毒副反应主要是白细胞减少,发生率为40.7%,Ⅲ度以上仅6.3%,血红蛋白下降及血小板减少分别为28.1%和18.7%,100%发生静脉炎,较重者占34.4%,停药后局部涂以扶他林软膏逐渐恢复.对治疗满3年的29例病人随访3年,随访率100%,1年生存率81.3%,2年生存率68.8%,3年生存率53.1%.[结论]5Fu长疗程静脉滴注,辅以醛氢叶酸及顺铂治疗转移性结直肠癌疗效较好,毒副作用较小.     

草酸铂联合氟尿嘧啶和四氢叶酸治疗晚期结直肠癌的疗效观察

目的探讨草酸铂联合氟尿嘧啶、四氢叶酸化疗方案对晚期结直肠癌的疗效和毒性反应.方法 29例晚期结直肠癌患者应用联合方案化疗,草酸铂85 mg/m2,第1,8天;CF 150 mg/m2,第1～5天;5-Fu 500 mg/m2,第1～5天.结果 CR 2例,PR 11例,总有效率44.8%.主要不良反应为骨髓抑制,白细胞下降占48.3%,但Ⅲ～Ⅳ度白细胞下降仅占6.9%.结论草酸铂联合氟尿嘧啶、四氢叶酸方案对晚期结直肠癌有较好疗效,不良反应可以耐受.     

奥沙利铂联合氟尿嘧啶及甲酰四氢叶酸治疗晚期大肠癌近期疗效分析

目的 :评价国产奥沙利铂 (oxaliplatin ,L OHP)联合氟尿嘧啶及甲酰四氢叶酸 (CF)治疗大肠癌的疗效和毒副反应。方法 :2 8例晚期大肠癌患者 ,予国产L OHP 12 0mg/m2 ,静脉滴入 ,持续 2h ;CF 15 0mg/m2 ,静脉滴入 ,持续 2h ;5 -氟尿嘧啶 ( 5 FU ) 5 0 0mg/m2 ,静脉滴入 ,持续 >4h ,于CF滴完后用。每 3周重复 1次 ,用药 2个周期后评价疗效。结果 :2 8例患者中 ,无完全缓解 (CR) ,部分缓解 (PR) 9例 ,稳定 (SD) 12例 ,进展 (PD) 7例 ,总有效率(RR ,CR PR) 3 2 1% ( 9/2 8) ,中位无进展生存期 6 7个月 ,中位生存期 9 8个月。毒副反应主要是末梢神经毒性、恶心呕吐、骨髓抑制及静脉炎等 ,患者均可耐受。结论 :国产L OHP联合 5 FU /CF治疗晚期大肠癌具有较好的疗效     

Oxaliplatin combined with 5-fluorouracil, leucovorin regimen for patients with advanced colorectal cancer

Objective： To observe the efficacy and tolerability of continuously infusing 5-fluorouracil （5-FU） / folic acid combined with oxaliplatin （L-OHP/5-FU/LV regimen） as first line treatment in advanced colorectal cancer. Methods： 23 patients of advanced colorectal cancer were treated with 5-FU 500 mg/d, civ, d 1-d5, d8-d12, leucovorin 100 mg/d, iv gtt, d1, d8, folic acid tablet 60 mg/d, po, d2-d5, d9-d12, and oxaliplatin 65 mg/（m^2·d）, iv gtt, dl, d8, repeated every 21 days （one cycle）. The effect was evaluated after two cycles. Results： Complete response in 2 cases and partial response in 10 cases were observed with an overall response rate of 47.18%. Adverse effects were mainly grade 1-2, including nausea, vomiting, diarrhea, dental ulcer, peripheral neuritis and myelosuppression. Conclusion： L-OHP/5-FU/LV regimen is an effective and better tolerated alternative treatment in advanced colorectal cancer and yields promising clinical application.     

草酸铂联合氟尿嘧啶、醛氢叶酸治疗晚期结直肠癌的临床观察

Objective:To observe the efficacy and tolerability of continuously infusing 5-fluorouracii(5-FU)/folic acid combined with oxaliplatin(L-OHP/5-FU/Lv regimen)as first line treatment in advanced colorectal cancer.Methods:23 patients of advanced colorectal cancer were treated with 5-Fu 500mg/d,civ,d1-d5,d8-d12,leucovorin 100mg/d,iv gtt,d1,d8,folic acid tablet 60 mg/d,po,d2-d5,d9-d12,and oxaliplatin 65mg/(m2-d),iv gtt,d1,d8,repeated every 21 days(one cycle).The effect was evaluated after two cycles.Results:Complete response in 2 cases and partial response in 10 cases were observed with an overall response rate of 47.18%.Adverse effects were mainly grade 1-2,including nausea,vomiting,diarrhea,dental ulcer,peripheral neuritis and myelosuppression.Conclusion:L-OHP/5-FU/LV regimen is an effective and better tolerated alterna tive treatment in advanced colorectal cancer and yields promising clinical application.     

L-OHP联合不同使用方法5-FU/FA方案治疗晚期结直肠癌的疗效比较

目的比较L-OHP(奥沙利铂)联合不同使用方法5-FUFA(氟尿嘧啶亚叶酸钙)方案治疗晚期结直肠癌的疗效及不良反应。方法62例患者均可参加疗效评价。ArmA方案(32例):L-OHP130mgm2静滴d1;FA200mg(m2·d),5-FU425mg(m2·d)分别静滴,均d1～5,每3周重复,3周为1周期。ArmB方案(30例):L-OHP85mgm2静滴d1;FA200mg(m2·d)静滴后,5-FU400mg(m2·d)静推,然后5-FU600mg(m2·d)持续微量泵注射22小时,d1～2,每2周重复,4周为1周期。结果ArmA方案CR1例,PR14例,总有效率46.9%。ArmB方案CR1例,PR11例,总有效率40%。严重不良反应较少。结论L-OHP联合不同使用方法5-FUFA方案治疗晚期结直肠癌均有较高疗效,毒副作用相近。     

Phase II study of irinotecan, 5-fluorouracil and leucovorin as first-line therapy for advanced colorectal cancer

BACKGROUND: We evaluated the efficacy and tolerability of a modified biweekly irinotecan, 5-fluorouracil and leucovorin regimen (modified Douillard regimen) as the first-line therapy in patients with advanced colorectal cancer. METHODS: A total of 80 patients (41 male, 39 female) with recurrent or metastatic colorectal cancer were enrolled between April 2001 and December 2003. The treatment cycle consisted of irinotecan 150 mg/m(2) as a 90 min infusion on day 1, leucovorin 20 mg/m(2) intravenous bolus, immediately followed by a 48 h continuous infusion of 5-fluorouracil 3000 mg/m(2) on day 1. The primary end-point was response rate, and the secondary end-points were time to progression and toxicity profile. RESULTS: An overall objective response rate of 38.7% [95% confidence interval (CI) 27.84-49.66%] was achieved. The median time to progression was 6.1 months (95% CI 4.63-7.57 months) and the median overall survival time was 20.2 months (95% CI 15.50-24.90 months). The median duration of follow-up for patients was 16.9 months. The toxicity profile was more favorable than for the conventional Douillard regimen. CONCLUSION: We conclude that the modified Douillard regimen may be a practical and more tolerable treatment option in patients with advanced colorectal cancer.     

5-氟尿嘧啶为主方案治疗晚期贲门癌及预后因素分析

采用以5-氟尿嘧啶（5-FU）为主的LF、PLF方案治疗晚期贲门癌,通过对其近期疗效、毒副反应及生存预后的分析,探讨晚期贲门癌的治疗与预后因素。34例晚期贲门癌患者进行非随机分组治疗,LF组：醛氢叶酸（LV,200mg／m^2,d1）静脉滴入2h加5-FU0．5g静脉推注及5-FU3．0g／m^2持续48h静脉滴入,2周重复;PLF组：醛氢叶酸（LV,200mg／m^2,d1）静脉滴入2h加5-FU0．5g静脉推注及5-FU3．0g／m^2持续48h静脉滴入联合顺铂（DDP,25mg／m^2,d1～d3）静脉滴入,3周重复。34例患者总有效率为47．06％,LF、PLF两组有效率分别为37．50％和55．56％,P=0．327;主要的不良反应为恶心呕吐、脱发、口腔黏膜炎、白细胞下降、血红蛋白下降等;上述毒副反应大多数为Ⅰ、Ⅱ度反应,且发生率不高,经常规对症治疗后见好转。全组中位生存期为8．0个月,LF、PLF组的中位生存期分别为5．0和12．4个月,P=0．4642。在预后方面,治疗前KPS评分、化疗疗程数是影响预后的相关因素（P值分别为0．016和0．001）。初步研究结果提示,以5-FU为主的LF、PLF方案治疗晚期贲门癌疗效和安全性好,PLF方案可推荐为晚期贲门癌化疗的一线治疗。治疗前KPS评分、化疗疗程数是影响预后的独立因素。     

5-FU加CF双周疗法联合腹腔化疗治疗晚期胃癌临床观察

目的:探讨5-氟尿嘧啶(5-FU) 醛氢叶酸(CF)双周疗法联合顺铂(DDP)、依托泊苷(Vp-16)腹腔化疗治疗晚期胃癌的疗效及不良反应。方法:103例患者按数字随机法分两组。观察组54例:CF200mg/m2,静脉滴入,后经留置中心静脉导管48h持续灌注高浓度5-FU3g/m2,腹腔化疗DDP80mg/m2、Vp-16200mg/m2,每2周重复。对照组49例:CF200mg/d、5-FU500mg/(m2·d),静脉滴入,d1~d5,DDP20mg/(m2·d)、Vp-1670mg/(m2·d),静脉滴入,d1~d4,每3周重复。结果:观察组和对照组有效率分别为64·8%和44·9%,KPS评分增高率分别为74·1%和53·1%,中位生存期分别为13和8·5个月,1年生存率分别为48·1%、38·8%,有效率及KPS评分增高率差异有统计学意义,P<0·05。两组骨髓毒性及消化道反应相似,P>0·05,观察组静脉炎、口腔黏膜炎明显减轻。结论:5-FU CF双周疗法联合腹腔化疗对晚期胃癌有效率高,不良反应较轻,生存质量提高。     

Trimetrexate as biochemical modulator of 5-fluorouracil/leucovorin in advanced colorectal cancer: final results of a randomised European study.

BACKGROUND: Trimetrexate (TMTX) is a biochemical modulator of 5-fluorouracil (5-FU) and leucovorin (LV). Phase II trials have shown promising activity of 5-FU/LV/TMTX in patients with advanced colorectal cancer (ACC). This trial evaluated the effect of TMTX in combination with 5-FU/LV as first-line treatment in ACC. PATIENTS AND METHODS: Patients with ACC were randomised to receive either intravenous LV 200 mg/m2/5-FU 600 mg/m2 or TMTX 110 mg/m2 followed 24 h later by LV 200 mg/m2/5-FU 500 mg/m2 plus oral LV rescue. Both schedules were given weekly for 6 weeks every 8 weeks. Patients were evaluated for progression-free survival (PFS), overall survival (OS), tumour response, quality of life (QoL) and toxicity. RESULTS: A total of 365 patients were randomised. A statistically significant prolongation of median PFS was seen in patients treated with TMTX/5-FU/LV compared with 5-FU/LV (5.4 months versus 4.1 months, respectively; P = 0.03), and a trend towards a significant benefit for OS (13.4 months versus 10.5 months, respectively; P = 0.08). Tumour response, QoL and toxicity were comparable between the two arms. Diarrhoea was the most frequently occurring grade 3 or 4 toxicity (22% and 30%, respectively). CONCLUSIONS: The addition of TMTX to a weekly regimen of 5-FU/LV results in a small but significant improvement in PFS without adding toxicity or worsening QoL in patients with ACC.     

奥沙利铂联合甲酰四氢叶酸和氟尿嘧啶治疗晚期结直肠癌的临床观察

目的:评价奥沙利铂(LOHP)联合氟尿嘧啶(5FU)、甲酰四氢叶酸(CF)治疗晚期结直肠癌的近期疗效和不良反应。方法:采用LOHP85mg/m2,静脉滴入,持续2h,d1;CF300mg,静脉滴入,持续1h,d1～d5;5FU500mg,静脉滴入,持续4h,d1～d5。21d为1个周期,治疗3个周期后评价疗效。结果:共治32例,CR0例,PR12例,MR10例,SD6例,PD4例,总有效率37.5%(12/32)。不良反应主要为轻度的感觉神经毒性,轻度骨髓抑制及恶心、呕吐。结论:LOHP、5FU和CF联合应用治疗复治晚期结直肠癌患者有一定的疗效,不良反应较轻。     

Integrated analysis of overall survival in two randomised studies comparing 5-fluorouracil/leucovorin with or without trimetrexate in advanced colorectal cancer.

BACKGROUND: Two randomised studies were performed with trimetrexate (TMTX) as a biochemical modulator of 5-fluorouracil (5-FU)/leucovorin (LV) in advanced colorectal cancer (ACC), one in Europe and one in the United States. Both studies were similarly designed to detect a statistically significant difference in progression-free survival (PFS). Overall survival (OS), however, was later adopted as the primary outcome measure for approvability of agents for first-line treatment of ACC. Therefore, an integrated analysis of survival data from the European and USA trials was performed to detect a clinically relevant difference in survival. PATIENTS AND METHODS: The experimental arm was identical in both studies and consisted of TMTX 110 mg/m2 intravenously (i.v.) followed 24 h later by i.v. LV 200 mg/m2/5-FU 500 mg/m2 plus oral LV rescue. The 5-FU dose in the control arm was 600 mg/m2 in the European study and 500 mg/m2 in the USA study, and the USA study was placebo-controlled. Treatment was given weekly for 6 weeks every 8 weeks. RESULTS: A total of 746 patients were analysed. Median OS was 13.0 months for 5-FU/LV and 14.6 months for TMTX/5-FU/LV (P = 0.15; Wilcoxon). Median PFS was 4.4 months and 5.4 months, respectively (P = 0.07; Wilcoxon). CONCLUSIONS: The addition of TMTX to a weekly regimen of 5-FU/LV does not improve the outcome for patients with ACC.