诱导化疗联合三维适形放疗加每周化疗治疗局部晚期胃癌32 例

 目的 探讨局部晚期胃癌的综合治疗方法。方法 32例局部晚期胃癌患者进入研究，以氟尿嘧啶为基础的联合方案诱导化疗2～3个周期后休息2～3周，采用三维适形放疗同步5-Fu500rag／（m² ·d），24h持续静脉滴注，每周1次，连续5周，亚叶酸钙200mg／m² ·d，24h持续静脉滴注，每周1次，连续5周。结果 32例适合进行统计分析，其1、3、5年生存率及局控率分别为90．6％、56．3％、37．5％及53．1％、28．1％、15．6％。主要毒副反应是胃肠道粘膜反应和粒细胞下降（主要为1～2级）。结论 诱导化疗联合三维适形放疗加同步氟尿嘧啶每周化疗治疗局部晚期胃癌可提高局部控制率，延长生存期，副反应可耐受。     

奥沙利铂联合替加氟和羟基喜树碱治疗晚期胃癌的研究

目的研究奥沙利铂联合替加氟和羟基喜树碱治疗进展及转移性胃癌的疗效和毒副反应。方法采用奥沙利铂130mg／m^2，静滴2小时，第一天；替加氟1．0，静滴2小时，第1—5天；羟基喜树碱10mg静滴2小时，第1—5天；21天或28天为1周期，行4周期治疗后判定疗效。结果其中完全有效3例(8．8％)，部分有效11例(32．4％)，无变化14例(41．2％)，进展6例(17．6％)，总有效率41.2％，中位生存期9个月。毒副反应以骨髓抑制，感觉性神经毒性为主，其中白细胞减少占44．1％，血小板减少占41．2％，感觉性神经毒性占82．4％，无化疗相关死亡。结论奥沙利铂联合替加氟和羟基喜树碱治疗晚期胃癌疗效肯定，毒副反应能耐受，值得进一步试用。     

多西紫杉醇联合奥沙利铂、卡培他滨与FOL FOX4 方案治疗晚期胃癌疗效比较

 目的 观察多西紫杉醇联合奥沙利铂、卡培他滨方案与FOLFOX4方案治疗晚期胃癌的客观疗效，疾病进展时间和毒性反应。方法 治疗组41例晚期胃癌患者接受多西紫杉醇25mg／m²（d1，d8，d15），奥沙利铂60mg／m^2（d1，d8，d15），卡培他滨每日1250mg／m²，分2次口服，d1～14，28d为1周期，疗程2～6周期。对照组40例晚期胃癌患者接受奥沙利铂85mg／m^2d1，亚叶酸钙200mg／m²（2h静脉输注）d1-d2，而后5-Fu400mg／m²（10min静脉推注）及5-Fu600mg／m²（持续静脉泵入22h），d1～d2，每14d重复，2次为1周期。结果 多西紫杉醇联合奥沙利铂、卡培他滨方案治疗组总有效率为58．5％，中位疾病进展时间（TTP）为6．8个月。常见的毒性反应为白细胞和中性粒细胞减低，手足综合征和周围神经毒性反应等。FOLFOX4方案总有效率为47．4％，中位TTP为5．9个月。常见的毒性反应为白细胞和中性粒细胞减低和周围神经毒性反应等。结论 多西紫杉醇联合奥沙利铂、卡培他滨化疗方案治疗晚期胃癌近期疗效显著，耐受性较好。     

替吉奥联合奥沙利铂治疗晚期胃癌的临床观察

目的 观察替吉奥(S-1)联合奥沙利铂治疗晚期胃癌的近期疗效和毒副反应.方法 33例晚期胃癌均接受化疗:替吉奥胶囊80 mg/(m2·d),早、晚餐后口服,d1～4;奥沙利铂130 mg/m2(2 h静脉滴注),d1;每21 d重复1次,至少2个周期.治疗结束后评价疗效和毒副反应.结果 CR 1例,PR 18例,SD ...     

紫杉醇联合奈达铂、替加氟治疗晚期食管癌的疗效观察

目的 观察紫杉醇联合奈达铂、替加氟治疗晚期食管癌的疗效和毒副反应.方法 入组55例晚期食管癌患者均接受化疗,方案:紫杉醇135 mg/m2,静脉滴注,d1;奈达铂25 mg/m2,静脉滴注,d2-4;替加氟500 mg/m2,静脉滴注,d2～6,21 d为1个周期,每2个周期治疗结束后评价疗效和毒副反应.结果 55例患...     

j奥沙利铂联合亚叶酸钙、替加氟治疗晚期大肠癌41例

目的观察奥沙利铂（L—OHP）联合亚叶酸钙（LV）、替加氟注射液治疗晚期大肠癌的疗效和毒副反应。方法经病理检查确诊的41例晚期大肠癌患者（初治组27例,复治组14例）给予奥沙利铂130mg／m2,静脉滴注3h,dl;亚叶酸钙100mg／m2,静脉滴注1h,dl—d5;替加氟800mg／m2,静脉滴注3h,d1～d5。每3周重复。结果全组完全缓解（CR）3例,部分缓解（PR）14例,稳定（SD）13例,进展（PD）11例。有效率（CR＋PR）为41．5％,其中初治组有效率为48．1％,复治组为28．6％（P〉0．05）。中位生存期10．7个月,KPS评分明显提高。毒副反应主要是末梢神经毒性、恶心呕吐及骨髓抑制等,患者均可耐受。结论奥沙利铂联合亚叶酸钙、替加氟注射液治疗晚期大肠癌具有较好的疗效,毒副反应可以耐受,生存质量较高,值得临床进一步推广应用。     

表柔比星联合奥沙利铂及替吉奥治疗晚期胃癌的近期疗效分析

目的观察表柔比星联合奥沙利铂及替吉奥治疗晚期胃癌的近期疗效及毒副反应。方法 11例经病理确诊的晚期胃癌患者接受化疗:表柔比星70 mg·m-2·d-1,静推,d1;奥沙利铂100 mg·m-2·d-1,静滴,d1;替吉奥80 mg·m-2·d-1,bid,口服,d1～14,每3周为1周期,化疗至少2周期后评价近期疗效和毒副反应。结果 11例患者中,CR 0例(0.00%),PR 5例(45.45%),SD 3例(27.27%),PD 3例(27.27%),有效率为45.45%,疾病控制率为72.73%。毒副反应主要是胃肠道反应、骨髓抑制,发生率分别为81.82%、72.73%,无治疗相关死亡。结论表柔比星联合奥沙利铂及替吉奥治疗晚期胃癌疗效较好,毒副反应可耐受。     

替吉奥胶囊联合奥沙利铂治疗晚期胃癌临床观察

目的 评价替吉奥胶囊联合奥沙利铂治疗晚期胃癌的安全性和有效性.方法 27例晚期胃癌分为两组.试验组14例:替吉奥胶囊80 mg/(m2·d),分2次口服,d1～14;奥沙利铂130 mg/m2,静脉滴注,d1.对照组13例:5-Fu 2400 mg/m2,静脉滴注,d1～5.5;CF0.2,静脉滴注,d1～5;奥沙利铂130 mg/m2,静脉滴注,d1.3周为1个周期.治疗2个周期后评价疗效和毒副反应.结果 试验组总有效率35.7%,对照组30.8%,差异无统计学意义(P＞0.05).两组主要毒副反应均为血液学毒性和消化道反应.结论 替吉奥胶囊联合奥沙利铂治疗晚期胃癌是安全、有效的.     

替吉奥胶囊联合奥沙利铂治疗晚期结直肠癌的临床观察

目的比较奥沙利铂联合替吉奥胶囊方案及FOLFOX4方案治疗晚期结直肠癌的临床疗效及毒副反应。方法46例晚期结直肠癌患者分为2组,观察组24例应用替吉奥胶囊联合奥沙利铂化疗,28d为1周期,至少完成2周期;对照组22例应用FOLFOX4方案化疗,28d为1周期,至少完成2周期。治疗后评价临床疗效和毒副反应。结果观察组有效率为54．17％,对照组为54．55％,差异无统计学意义（P〉0．05）。观察组毒副反应发生率稍低于对照组,但差异均无统计学意义（P均〉0．05）。结论替吉奥胶囊联合奥沙利铂疗效与传统的FOLFOX4方案相近,且安全性及患者耐受性方面具有一定优势,可作为晚期结直肠癌患者的治疗方案用于临床。     

GP 方案双路腹腔温热灌注化疗并全身化疗治疗晚期胰腺癌临床观察

 目的 探讨晚期胰腺癌腹腔双路温热灌注化疗并全身化疗的效果。方法 选择经病理确诊的晚期胰腺癌患者26例,行腹腔单点穿刺灌注40℃的0.9%的生理盐水2500ml～3500ml＋顺铂80～100mg/m²＋地塞米松10mg＋速尿40mg的混合液d1。腹腔给药的同时,静脉滴注林格氏液1500ml＋硫代硫酸钠（STS）20～40g,12h滴完,顺铂与STS的用量比例为1∶200。次日STS的剂量减半静脉滴注12h;吉西他滨1.0～1.25g/m²ivdripd1,8。3～4周为1周期,共4周期。并观察其疗效及毒副反应。结果 按WHO实体瘤近期疗效评价标准评价,26例患者均可评价,其中位生存期8个月,总有效率为38.5%,主要毒副反应为骨髓抑制。其他毒副反应较轻,一般可以耐受。结论 GP方案行双路腹腔温热灌注化疗治疗晚期胰腺癌的临床疗效较好,值得进一步探讨。     

多西紫杉醇联合氟尿嘧啶及顺铂治疗晚期胃癌

 目的 观察国产多西紫杉醇（TAT）联合亚叶酸钙／5-氟尿嘧啶（CF／5Fu）及顺铂（DDP）治疗晚期胃癌的临床疗效与不良反应。方法 41例晚期胃癌患者接受TAT与CF／5-Fu及DDP联合化疗：TAT75mg／m2，静滴1h，d1；CF100mg，静滴2h，d1-5；5-Fu500mg／m2，22h微泵持续静滴，d1-5；DDP25mg／m2，静滴，d，1-3。28天为一个周期。治疗2个周期后评价疗效和不良反应。结果 41例患者均可评价疗效。完全缓解2例，部分缓解23例，有效率61．0％。中位疾病进展时间7．5个月，中位生存期10．6个月，1年生存率41．5％。主要不良反应为骨髓抑制，脱发和周围神经炎。结论 国产多西紫杉醇联合亚叶酸钙／5-氟尿嘧啶及顺铂治疗晚期胃癌缓解率高，毒副反应可以耐受。     

羟基喜树碱联合奥沙利铂、氟尿嘧啶和亚叶酸钙治疗晚期胃癌的临床研究

目的　观察羟基喜树碱（ＨＣＰＴ）联合奥沙利铂（ＯＸＡ）、氟尿嘧啶（５ ＦＵ）及亚叶酸钙（ＣＦ）联合治疗晚期胃癌的近期疗效及毒副反应。方法　ＨＣＰＴ１０ｍｇ／ｍ^２静脉滴注,ｄ_１～ｄ_５;ＯＸＡ１００ｍｇ／ｍ^２静脉滴注,ｄ_１;５-ＦＵ７５０ｍｇ／ｍ^２静脉滴注,ｄ_６～ｄ_１０;ＣＦ１００ｍｇ／ｍ^２静脉滴注,ｄ_６～ｄ_１０。每２８天为１个周期,连续２个周期后评价疗效。结果　５４例均可评价疗效,ＣＲ４例,ＰＲ２７例,有效率为５７.４％,中位疾病进展时间（ＴＴＰ）为４.５个月,中位总生存时间（ＯＳ）８个月。主要毒副反应为白细胞减少、血红蛋白减少、胃肠道反应和脱发。结论　ＨＣＰＴ联合ＯＸＡ、５-ＦＵ、ＣＦ治疗晚期胃癌有较好的疗效,且毒性可以耐受,值得进一步研究。     

草酸铂联合氟尿嘧啶和亚叶酸钙治疗晚期胃癌

目的观察草酸铂(L-OHP)联合氟尿嘧啶(5-Fu)和亚叶酸钙(CF)治疗晚期胃癌的疗效及毒副反应。方法第1天采用L-OHP130mg/m2静脉滴注3h,CF200mg静脉滴注2h后,5-Fu500mg快速静脉注射后再用5-Fu2.4g/m2持续静脉滴注泵连续滴注46h,每3周重复,完成3周期后评价疗效,有效病例4周后确认。结果全组46例晚期胃癌患者,CR3例,PR20例,有效率(CR+PR)50%,中位疾病进展时间(TTP)5.7月,中位生存期10.5月。主要不良反应为轻度感觉神经毒性、恶心呕吐及骨髓抑制。结论草酸铂联合氟尿嘧啶和亚叶酸钙治疗晚期胃癌疗效较好,不良反应轻,可耐受。     

Clinical Research on Use of Oxaliplcrtin in Combination with HCPT, LV and 5FU in a Regimen for Advanced Gastric Cancer

OBJECTIVE To observe the effects and adverse reactions of a OXA-HCPT LV/5FU 3 regimen for patients with advanced gastric cancer.METHODS OHLF3 regimen: OXA 130 mg/m^2iv d 1, HCPT6 mg/m^2, iv d 1-5, LV 200 mg/m2iv 2 h followed by a 5FU 400 mg/m2 iv bolus and 5FU 600mg/m2 iv d 1-3, were given, every 21 days as 1 cycle. Assessment of the tumor was conducted after 3 cycles and the effective cases were confirmed after 4 weeks.RESULTS Among 39 patients, 36 were actually evaluable. Overall response rates (CR PR} were 50%‘ the major adverse reactions were mild hematological toxicity, nausea and vomiting and peripheral nerve abnormalities.CONCLUSION The OHLF 3 regimen using OXA and HCPT is effective and results in mild toxicity when used in combined chemotherapy for advanced gastric cancer.     

Phase II study of sequential high-dose methotrexate (MTX) and 5-fluorouracil (F) alternated with epirubicin (E) and cisplatin (P) [FEMTX-P] in advanced gastric cancer

BACKGROUND:: FAMTX (5-fluorouracil, adriamycin, methotrexate) is one of themost effective drug combinations in gastric cancer. Therefore,modifications of FAMTX appear of interest and the FEMTX-P regimentwas conceived. PATIENTS AND METHODS:: Fifty patients with unresectable locally advanced and/or metastaticgastric carcinoma were treated with methotrexate 1500 mg/m²i.v. and 5-fluorouracil 1500 mg/m² i.v. on day 1; leucovorinrescue 15 mg/m² orally every 6 hours for 8 doses on days 2 and3; epirubicin 60 mg/ m² i.v. and cisplatin 50 mg/m² i.v. onday 15, q 4 weeks. RESULTS:: Of forty-seven patients evaluable for response, five (11%) achievedcomplete responses and seventeen (36%) partial responses (totalresponse rate 47%). The median duration of response was 8+ months(range: 5–25+ months). Four of 14 patients with locallyadvanced disease were successfully downstaged and subsequentlyresected. The median duration of survival of all patients was10 months (range: 1–25+ months). Leukopenia grade 4 occurredin 18% of patients and thrombocytopenia grade 4 and mucositisgrade 4 in 4% and 2%, respectively. Treatment postponement forhematologic toxicity was necessary in 54% of patients. CONCLUSIONS:: The FEMTX-P regimen is an active regimen in advanced gastriccarcinoma, with acceptable toxicity. chemotherapy, FEMTX-P, gastric cancer     

5-Fluorouracil, folinic acid, epidoxorubicin and cisplatin (FLEP) combination chemotherapy in advanced measurable gastric cancer. A phase II trial of the Spanish Cooperative Group for Gastrointestinal Tumor Therapy

BACKGROUND:: Metastatic disease is a common problem in gastric cancer andthe development of better chemotherapeutic regimens is a clearpriority in gastrointestinal oncology. PATIENTS AND METHODS:: Ninety consecutive, previously untreated patients with unresectableor measurable metastatic gastric cancer were included in a multicenterphase II trial with a combination of folinic acid (200 mg/m²)and 5-fluorouracil (400 mg/m²) days 1-3, with epidoxorubicin(60 mg/m²) and cisplatin (100 mg/m²) on day 2. RESULTS:: A total of 376 courses of FLEP were given, with a median offour courses per patient. Objective responses were observedin 32 (35%) patients (CI at 95%: 25.7%-46.3%). Eight (9%) patientsexperienced clinical complete remissions. Median time to progressionwas 25 weeks for the entire group of patients and 38 weeks forresponders. Myelo-suppression was the primary toxicity. WHOgrade 3 leuko-penia appeared in 26 patients (29%). Ten presentedepisodes of febrile neutropenia requiring hospitalization, butno toxic deaths were observed. Grades 3 and 4 thrombocytopeniawere seen in 8 and 1 patients, respectively. Median survivaltime was 8 months for all treated patients and 11 months forresponders. CONCLUSIONS:: The FLEP regimen is an active combination in advanced gastriccancer with moderate toxicity that warrants further testingin a phase III trial. advanced gastric cancer, combination chemotherapy, phase II trial     

Combination 5-fluorouracil (FU), folinic acid (FA), and {alpha}-interferon 2B in advanced gastric cancer: Results of a phase II trial

BACKGROUND: Based on encouraging treatment results with FU/FA or FU/IFNin gastrointestinal tract cancer, a phase II study was conductedto evaluate the effects and toxicity of combination FU/FA/IFNin patients (pts) with inoperable/metastatic gastric cancer. PATIENTS AND METHODS: IFN 6 M.U. s.c. 1 x/week, FU 500 mg/m² bolus i.v. 1 x/week andFA 500 mg/m² 1 x/week as a 2-hour infusion. Of 72 treated pts,72 (22 females, 50 males) are evaluable for response and toxicity.Median age was 55.6 years (28-80), and median Karnofsky performancestatus was 80% (70–100). Sites of measurable disease wereinoperable primary tumors/local recurrence (18), liver metastasis(22), lymph nodes (31) and peritoneum (20). One pt had bonemarrow metastasis and another had paraneoplastic hyperfibrinolyticcoagulopathy. RESULTS: 10/72 pts had complete response, 20/72 pts par tial response,40/72 pts tumor stabilization and 2/72 pts progressive disease.The median duration of response (CR/PR) was 9 months, the medianprogression-free interval 6 months, the median survival timewas 9 months, and for responding patients (CR/PR) 12.5 months.Toxicity: 1/72 pts had WHO grade 4 toxicity (diarrhea), 5/72pts had WHO grade 3 toxicity (nausea 1, diarrhea 4). Exceptfor 1 treatment-limiting grade 4 toxicity, no modificationsof dose or schedule due to toxicity were required. Thirty-sixof 44 pts experienced a significant reduction in tumor-relatedpain under treatment. CONCLUSION: Biochemical modulation of FU with FA and IFN is effective inadvanced gastric cancer. Moderate toxicity, outpatient treatmentsetting and high rates of amelioration tumor-related pain contributeto an effective palliation. advanced gastric cancer, double modulation of FU, phase II trial     

草酸铂联合羟基喜树碱、氟脲嘧啶、甲酰四氢叶酸钙治疗晚期胃癌36例的疗效观察

目的:观察舍草酸铂和羟基喜树碱的联合化疗方案治疗晚期胃癌的近期疗效及不良反应.方法:化疗方案(OHLF3方案):草酸铂130mg/m2,静滴,第1日;羟基喜树碱6mg/m2,静滴,第1～5日;甲酰四氢叶酸钙200mg/m2,静滴2小时,第1～3日;5-氟脲嘧啶400mg/m2,快速静注,追加600mg/m2,持续静滴22小时,第1～3日,每21日为一周期,完成3周期后判定疗效,有效病例4周后确认.结果:全组39例患者,实际可评价疗效患者36例,总有效率(CR PR)为50%(1818/36);主要不良反应为轻度的血液学毒性、恶心呕吐和外周感觉神经异常.结论:含草酸铂和羟基喜树碱的OHLF3方案是治疗晚期胃癌有效且毒性较小的联合化疗方案.     

奥沙利铂联合5-氟尿嘧啶和醛氢叶酸钙时辰治疗晚期胃癌的初步临床研究

目的观察奥沙利铂(L-OHP)联合5-氟尿嘧啶(5-Fu)、醛氢叶酸钙(FA)方案(FFL方案)时辰输注法治疗晚期胃癌的疗效和不良反应。方法FFL方案时辰输注法治疗26例晚期胃癌患者,L-OHP 25 mg.m-2.d-1,5-Fu 600 mg.m-2.d-1,FA 300 mg.m-2.d-1,多通道程控时辰输液泵连续给药4 d,每14 d为1个周期,至少用2个周期。结果26例晚期胃癌患者中,完全缓解(CR)2例(7.7%),部分缓解(PR)13例(50.0%),稳定(SD)6例(23.1%),进展(PD)5例(19.2%),总有效率为57.7%。在共80个周期的化疗中,最常见的不良反应为血液学毒性、胃肠道毒性、外周神经毒性,但均以Ⅰ度为主,Ⅲ度中性粒细胞减少发生2例次,血小板减少、呕吐和口腔黏膜炎分别发生1例次,未出现Ⅳ度不良反应。中位缓解时间为3.5个月,中位肿瘤进展时间为4.5个月,全组患者中位生存期为8个月。结论FFL方案时辰输注法是治疗晚期胃癌安全有效的化疗方案。     

替吉奥与FLO治疗老年进展期胃癌的对照研究

目的：对比观察口服替吉奥胶囊与FLO化疗在老年进展期胃癌的疗效及毒副反应。方法：将2007年8月至2010年11月收治于河北大学附属医院的56例老年进展期胃癌患者分为两组：口服组（26例）,替吉奥胶囊,每次40mg/m2,2次/d,连续口服14天,休息7天,21天1周期;静脉组（30例）,L-OHP 85mg/m2,第1天,5-FU 2400mg/m2,48小时持续泵入,亚叶酸钙200mg/m2,第1天,21天1周期。结果：口服组与静脉组的疾病控制率（DCR）（76.9% vs 83.3%,P=0.547）,中位PFS（4.2 vs 5.5个月,P=0.422）,中位OS（9.6 vs 10.5个月,P=0.531）,两组未见显著性差异。两组1年生存率分别为24%与27%（P=0.626）。毒性反应主要为骨髓抑制及胃肠道反应,全组无Ⅳ度毒副反应发生,口服组在白细胞减少（46.2% vs 66.7%, P=0.050）及恶心呕吐（34.6% vs 83.3%,P=0.000）有统计学差异;口服组皮肤色素沉着发生率明显高于静脉组（57.7% vs 30.0%,P=0.010）。结论：老年进展期胃癌口服用药可减轻毒副反应,耐受性好,且与静脉给药疗效相当。