L-OHP联合5-FU/LV二线治疗晚期肠癌26例分析

我科2004—06／2006—07应用L—OHP联合5-FU／LV治疗晚期大肠癌26例，分析如下。 1 临床资料 1．1 一般资料 本组均经病理学检查确诊，其中男16例，女10例，年龄49～77岁，中位年龄68岁，结肠癌17例；其中肝转移16例，局部复发2例，腹膜转移2例，骨转移2例，肺转移2例，入组前均于6个月内接受过5-FU／LV治疗，分别联合顺铂（PDD），羟基喜树碱（HCPT）等，但未使用过L—OHP且近4周内未行化疗，     

CPT-11联合5-FU/CF方案二线治疗晚期结直肠癌的临床研究

目的探讨伊立替康（CPT-11）联合5-氟尿嘧啶/甲酸四氢叶酸（5-FU/CF）（FOLFIRI）方案二线治疗晚期结直肠癌的疗效及不良反应。方法回顾分析42例晚期结直肠癌患者经5-FU和奥沙利铂类药物一线化疗失败后行FOLFIRI方案治疗。CPT-11 180 mg.m-2,静脉滴注90 min,第1天;CF400 mg.m-2,静脉滴注2 h,第1天;5-FU400 mg.m-2,静脉推注,随后5-FU2.4 g.m-2,静脉滴注46 h（泵入）,第1天。每14天重复。分析其近期疗效及不良反应。结果42例患者中41例可评价疗效,有效率RR为11.9%,无进展生存期（PFS）为3.7个月,总生存期（OS）为11.0个月。主要的Ⅲ/Ⅳ度不良反应是中性粒细胞减少（16.7%）、迟发性腹泻（9.5%）和恶心呕吐（7.2%）。结论FOLFIRI方案二线治疗5-FU和奥沙利铂类药物治疗失败的晚期结直肠癌是有效的,不良反应能控制。     

奥沙利铂联合CF／5-FU持续静脉输入治疗晚期结直肠癌临床观察

奥沙利铂（Oxaliplation，L—OHP）具有抗肿瘤谱广，抗癌活性高，与顺铂无交叉耐药，与5-氟脲嘧啶（5-FU）有明显协同作用，无肾毒性，已广泛应用于多种恶性肿瘤化疗。作者2004年2月至2005年12月应用奥沙利铂联合亚叶酸钙（CF）和5-FU持续72h静脉输入治疗晚期结直肠癌38例，结果报道如下。     

奥沙利铂联合亚叶酸钙和氟尿嘧啶治疗晚期大肠癌的疗效分析

目的：观察奥沙利铂（OXA）联合亚叶酸钙（CF）和氟尿嘧啶（5-FU）治疗晚期大肠癌的近期疗效和毒副作用。方法：35例患者均接受奥沙利铂（OXA）130mg／m^2＋5%葡萄糖注射液500ml静脉滴注3h，第1天；CF200mg／m^2＋0．9%生理盐水注射液250ml静脉滴注约2h，D1-5。然后给予5-FU350mg／m^2静脉滴注约4～6小时D1-5。21d为一周期，至少应用2周期后判定疗效。结果：可评价疗效32例，完全缓解（CR）2例，部分缓解（PR）13例，总有效率达46．8%。可评价毒性患者35例，骨髓抑制为主要毒副作用，白细胞下降达93．7%；血小板下降43．7%，恶心呕吐发生率82.2%，腹泻则为37．5％；另外周围神经毒性高达50％。结论：OXA联合CF＋5-FU治疗晚期大肠癌有较好疗效，毒性反应轻，可耐受，值得在临床上进一步推广。     

草酸铂联合氟尿嘧啶／亚叶酸钙治疗晚期大肠癌的临床观察

目的：观察草酸铂（OXA）联合氟尿嘧啶（5-FU）／亚叶酸钙（CF）治疗晚期大肠癌的近期疗效和毒副作用。方法：26例患者接受FCO方案：OXA130mg／m^2，静滴，d1；CF200mg／m^2，静滴，d1-d5；5-FU500mg／m^2，静滴，d1-d5。26例患者接受FCP方案；顺铂（PDD）20mg／m^2，静滴，d1-d5；CF200mg／m^2，静滴，d1-d5；5-FU500mg／m^2，静滴，d1-d5。两方案均是21天为1周期，3周期后判定疗效。结果：FCO组26例，完全缓解3例，部分缓解11例，有效率53．9％。Ⅲ-Ⅳ度恶心、呕吐发生率11．5％；肾脏毒性发生率3．9％。FCP组26例，完全缓解1例，部分缓解10例，有效率42．3％。Ⅲ-Ⅳ度恶心、呕吐发生率84．6％；肾脏毒性发生率34．5％。结论：OXA联合5-FU／CF治疗晚期大肠癌的疗效较好，毒性反应轻可耐受，值得临床推广应用。     

OXA+5-FU2/LV方案治疗大肠癌副反应的观察与护理

20 0 3年 8月 ,我科采用中国抗癌协会推荐的奥沙利铂(OXA)、氟脲嘧啶 5_FU、亚叶酸钙 (LV)方案 ,治疗晚期大肠癌2 8例。该方法不但延长了患者的生存时间 ,而且避免了患者反复穿刺的痛苦 ,减少并发症的发生 ,提高了肿瘤患者的生存质量 ,现报告如下。资料与方法1 一般资料。本组 5 8例均经病理或细胞学证实 ,男 39例 ,女 19例 ,年龄 2 8～ 74岁 ,平均年龄 5 5 .2岁。其中应用OXA +5_FU2 /LV方案可评价的治疗组 2 8例 ,应用顺铂 (DDP)+LV +5_FU方案可评价的对照组 30例。按大肠癌国际分期标准临床分期为Ⅲ～Ⅳ期 ,化疗至少 2个周期以…     

伊立替康联合卡培他滨治疗晚期结直肠癌的临床观察

[目的]评价伊立替康（CPT-11,irinotecan）联合卡培他滨（capecitabine）方案治疗晚期结直肠癌的近期疗效与不良反应。[方法]伊立替康150 mg/m2静脉滴注d1,d8,卡培他滨1 000 mg/m^2,口服,2次/天,d1-14,治疗24例术后曾接受过OXA＋5-Fu/LV,HCPT＋5-Fu/LV方案化疗后复发和（或）转移的结直肠癌,每3周重复,至少完成2个周期。[结果]全组共化疗108周期,平均4.5周期/例。24例化疗后完全缓解（CR）1例（4.2%）,部分缓解（PR）10例（41.7%）,疾病稳定（SD）10例（41.7%）,疾病进展（PD）3例（12.5%）,有效率（RR）45.8%。中位生存期11.2个月。主要不良反应为白细胞下降（62.5%）、迟发性腹泻（58.3%）、手足综合征（33.3%）,无化疗相关死亡。[结论]伊立替康联合卡培他滨方案治疗晚期结直肠癌疗效高,毒副作用可较好耐受。     

结直肠癌联合化疗对血小板的毒性与氨磷汀解毒作用的临床观察

结直肠癌的联合化疗进展较快，特别是FOLFOX方案（亚叶酸＋5-氟尿嘧啶＋奥沙利铂）、FOLFIRI方案（亚叶酸＋5-氟尿嘧啶＋伊利替康）和XELOX方案（希罗达＋奥沙利铂）等联合化疗，被临床证明具有较高的有效性而成为近年临床肿瘤学重大进展。现已成为结直肠癌术后辅助化疗的首选方案和晚期姑息治疗的重要手段。但是结直肠癌常用的联合化疗方案一般6个疗程，共12次治疗，     

草酸铂分别联合替加氟和5-FU治疗胃肠道肿瘤的疗效观察

目的观察草酸铂分别联合替加氟和5-FU治疗晚期胃肠道肿瘤的近期疗效及其毒副反应。方法草酸铂130mg／0第1天；醛氢叶酸200mg1～5天；替加氟1．0g第1～5天，或5-FU375mg／m2第1—5天；21天为一周期，2周期做一次疗效评价。结果5-FU组总有效率30％，替加氟组总有效率43．3％。替加氟较5-FU疗效明显，主要毒副反应为恶心、呕吐和白细胞减少等，但替加氟组毒副反应明显低于5-FU组。结论草酸铂联合替加氟组治疗晚期胃肠道肿瘤疗效较联合5-FU组好，毒副反应较轻，可作为晚期胃肠道肿瘤的一线方案。     

草酸铂联合氟尿嘧啶/亚叶酸钙治疗晚期大肠癌的临床观察

目的：观察草酸铂（OXA）联合氟尿嘧啶（5-FU）／亚叶酸钙（CF）治疗晚期大肠癌的近期疗效和毒副作用。方法：26例患者接受FCO方案：OXA 130mg／m^2，静滴，d1；CF 200mg／m^2，静滴，d1～d5；5-FU 500mg／m^2，静滴，d1-d5。26例患者接受FCP方案：顺铂（PDD）20mg／m^2，静滴，d1-d5；CF200mg/m^2，静滴，d1-d5；5-FU 500mg／m^2，静滴，d1-d5。两方案均是21天为1周期，3周期后判定疗效。结果：FCO组26例，完全缓解3例，部分缓解11例，有效率53．9％。Ⅲ—Ⅳ度恶心、呕吐发生率11．5％；肾脏毒性发生率3．9％。FCP组26例，完全缓解1例，部分缓解10例，有效率42．3％。Ⅲ-Ⅳ度恶心、呕吐发生率84．6％；肾脏毒性发生率34．5％。结论：OXA联合5-FU／CF治疗晚期大肠癌的疗效较好，毒性反应轻可耐受，值得临床推广应用。     

Oxaliplatin with weekly bolus 5-fluorouracil and leucovorin in pretreated advanced colorectal cancer patients: a phase II study

BACKGROUND: The purpose of this study was to determine the efficacy and toxicity of oxaliplatin in combination with weekly bolus 5-fluorouracil (5-FU) and leucovorin (LV) in patients with 5-FU-pretreated advanced colorectal cancer. METHODS: A total of 39 patients with documented 5-FU-resistant advanced colorectal cancer were enrolled. All 39 patients had previously received weekly high-dose 5-FU/LV (2,600 mg/m(2) 5-FU plus 100 mg/m(2) LV as 24-hour infusion) as first-line chemotherapy for metastatic disease. Oxaliplatin (85 mg/m(2)) was delivered as an intravenous infusion over 2 h on days 1 and 15, while 5-FU (500 mg/m(2)) and LV (20 mg/m(2)) were administered as an intravenous bolus on days 1, 8 and 15. One treatment course consisted of 3 consecutive weeks of therapy followed by a 1-week rest. RESULTS: In an intent-to-treat analysis, the objective response rate for the 39 patients was 20.5% (95% confidence interval, 7.2-33.8%). The disease was stable in 19 patients (48.7%), and progressive in 11 (28.2%). The median survival for all 39 patients was 8.9 months. The median time to progression was 5.0 months. Grade 3/4 neutropenia occurred in only 1 patient (2.6%), and grade 2 and 3/4 peripheral neuropathy occurred in 10 (25.6%) and 5 (12.8%) patients, respectively. CONCLUSION: Oxaliplatin in combination with weekly bolus 5-FU/LV is also active in patients with advanced colorectal cancer where first-line treatment has failed.     

以草酸铂为主的联合化疗治疗晚期胃肠道癌的临床研究

目的 评价草酸铂联合5-FU和C17治疗晚期胃肠道恶性肿瘤的疗效、耐受性及毒副反应。方法 55例晚期胃肠道癌病人，应用OXA130mg／m^2第一天静点4小时，CF7100mg/m^2，第一天至第五天静点，5-FU400mg／m^2，第一天至第五天静点。21天重复，2周期以上评价疗效。结果总有效率50．9％，完全缓解率3．6％。毒性反应以恶心、呕吐常见，其次为骨髓抑制、腹泻、末梢神经炎，但反应轻微。结论 OLF方案是治疗晚期胃肠道恶性肿瘤较好的方案，毒副作用可以耐受。     

Epirubicin, cisplatin and continuous-infusion 5-fluorouracil (ECF regimen) in the treatment of advanced colorectal cancer.

Thirty-one patients with advanced colorectal cancer were treated with a regimen of epirubicin, cisplatin and continuous-infusion (c.i.) 5-fluorouracil (5-FU) (ECF regimen). Twenty-seven patients were evaluable for response rate (RR), progression-free survival (PFS) and overall survival (OS). In this study, the ECF chemotherapy yielded a 51% RR with a PFS of more than 8 months, an OS of more than 11 months and tolerable toxicity. In spite of the perplexity concerning the use of anthracyclines in colorectal cancer, the ECF regimen seems to be a possible treatment even for this malignancy. Controlled studies with ECF versus standard treatments and versus 5-FU alone in c.i. are necessary.     

雷替曲塞联合奥沙利铂治疗晚期结肠、直肠癌的临床研究

目的评价雷替曲塞联合奥沙利铂（L-OHP）治疗晚期结肠、直肠癌的疗效和安全性。方法 40例晚期结肠、直肠癌患者分为2组：试验组20例,给予雷替曲塞联合奥沙利铂治疗,对照组20例,5-Fu/LV方案联合奥沙利铂治疗。观察2组的临床疗效及安全性。结果试验组RR为40.0%,DCR为80.0%,对照组RR为30.0%,DCR为70.0%,2组比较差异无统计学意义（P〉0.05）;试验组恶心呕吐、腹泻、口腔黏膜损害发生率明显低于对照组（P〈0.05）。结论雷替曲塞联合L-OHP方案较传统的以5-Fu为基础的联合化疗方案使用方便,缩短住院时间,并且在有效率方面不劣于以FU为基础的联合化疗,是值得推荐的治疗晚期结肠、直肠癌的化疗方案。     

奥沙利铂联合亚叶酸钙/5-氟脲嘧啶持续泵入治疗晚期胃肠癌的临床观察

目的观察奥沙利铂(L-OHP)联合亚叶酸钙(CF)、5-氟脲嘧啶(5-FU)方案对晚期胃肠癌病人的近期疗效。方法26例晚期胃肠癌患者化疗前经锁骨下静脉留置管内给药。L-OHP150mg/m2,静滴3h,第1天;CF100mg/d,静滴2h,第1～5天;5-FU1000mg/m2,微量泵持续泵入,第1～2天,每14d为1个周期。结果全组26例骨髓抑制发生率为57.7%,Ⅲ/Ⅳ度者仅1例。胃肠道反应主要为口腔粘膜炎与腹泻,发生率为53.8%,无Ⅲ/Ⅳ度胃肠道反应。结论L-OHP联合CF/5-FU持续泵入治疗晚期胃肠癌的近期疗效较好,药物不良反应低,病人耐受性好,值得推广。     

Folinic acid (FA) plus 5-fluorouracil (FU) in progressive advanced colorectal cancer

Treatment results (CR/PR** 30-40%) with the combination of 5-FU and FA--a biomodulator of 5-FU action--indicate that FA/5-FU is superior to 5-FU alone in the treatment of advanced colorectal cancer. However the "optimal" dose and time schedule has not been properly defined either for FA or for 5-FU. Moreover, in spite of the promising reports with FA/5-FU, the benefit of chemotherapy in colorectal carcinomas remains unproven. One way to better define the impact on survival and palliation might be to select patients with a documented tumor progression prior to chemotherapy. In 2 prospective phase II studies with FA/5-FU, tumor progression was the essential eligibility criterion. In both studies an overall tumor control (CR/PR/MR/NC)** of progressive disease with relief of tumor-related symptoms in most of the patients was achieved. The median survival times exceeded 12 months. In progressive colorectal cancer these treatment results can be regarded as a significant change in the natural history of the disease. Moreover, such a procedure will help to define more homogeneous patient groups and contribute to a better comparability of different studies. Additionally, overtreatment of patients with slowly proliferating tumors can be avoided, particularly with respect to the subjective and objective side-effects of FA/5-FU combinations.     

Bimonthly Regimen of High-Dose Leucovorin, Infusional 5-Fluorouracil, Epirubicin and Cisplatin (Modified ECF) as Adjuvant Chemotherapy in Resected Gastric Adenocarcinoma

Background: The administration of the de Gramont regimen in combination with cisplatin and epirubicin (modified ECF) has previously been reported as a treatment for advanced gastric cancer, but here we report this regimen combination in an adjuvant setting for the first time. Methods: Forty-eight patients with curatively resected gastric cancer were treated. Each 2-week cycle consisted of epirubicin (50 mg/m(2)), cisplatin (50 mg/m(2)), 5-fluorouracil (5-FU) IV bolus (400 mg/m(2)) and 5-FU IV (2,400 mg/m(2)) over 46 h plus leucovorin IV (400 mg/m(2)) over 2 h. Postoperative chemoradiotherapy was also administered to the patients when indicated. We retrospectively reviewed the patients who were treated with modified ECF. Results: The median disease-free survival (DFS) was 40.7 months and the 1-, 3- and 5-year DFS rates were 78.5, 55.7 and 44.6%, respectively. The most common grade 3-4 toxicities were hematological and gastrointestinal. Conclusion: A modified ECF regimen may be an effective and convenient treatment with tolerable toxicities for the adjuvant treatment of gastric cancer. It may provide an alternative regimen to the standard ECF when a continuous ambulatory infusion pump is not feasible or not preferred by the patient.     

国产多西紫杉醇加奥沙利铂加LV5FU3方案治疗晚期胃癌临床研究

目的评价国产多西紫杉醇(艾素) 奥沙利铂(艾恒) LV5FU3方案(艾素 FOLFOX方案)治疗晚期胃癌的疗效及毒性。方法35例进入该临床研究,并按下列方法治疗:艾素85 mg/m2分2次,d1、d8;艾恒130 mg/m2分2次、d1、d8;甲酰四氢叶酸钙(CF)200 mg/m2静滴2 h d1;氟尿嘧啶(5-FU)300 mg/m2静推(CF后进行)d1;5-FU500mg/m2持续输注24 h(5-FU静推后进行)1次/d(3 d1-3;以上化疗每3周重复。所有病人接受2周期及以上化疗,平均3.2周期。结果客观有效率为82.2%(29/35)。肿瘤进度时间(TTP)为4.5月。主要毒副作用为骨髓抑制、恶心/呕吐和口腔炎。没有严重化疗并发症发生。化疗后7例做了手术治疗。结论艾素 艾恒 LV5FU3方案(艾素 FOLFOX方案)治疗晚期胃癌是可行的和有效的方案。该方案价值有待进一步研究,临床上可有选择地应用。     

Gemcitabine combined with infusional 5-fluorouracil and high-dose leucovorin for the treatment of advanced carcinoma of the pancreas

BACKGROUND: 5-Fluorouracil (5-FU) and gemcitabine are the major active drugs in the treatment of pancreatic cancer. METHODS: Twenty-two patients with advanced pancreas cancer were treated with a new chemotherapy regimen consisting of infusional 5-FU and high-dose leucovorin with gemcitabine (GEMFUFOL). RESULTS: A total of 200 cycles of chemotherapy were administered. The response rate was 27.3%, all responses being partial. The median survival time and 1-year survival rate were, respectively, 13 months and 60.4%. The toxicity was very low and severe hematological toxicity was exceptional. CONCLUSION: The GEMFUFOL regimen can be an active regimen for the treatment of advanced pancreatic cancer and has a low toxicity.     

In vitro models of a three-drug regimen (epirubicin, cisplatin and fluorouracil) for the treatment of colorectal cancer.

The activity of epirubicin, cisplatin and 5-fluorouracil (5-FU), as single agents or in combination (ECF), was investigated in three human colon cancer cell lines by two different assays (cell-counting assay and sulforhodamine B assay) in vitro. 5-FU was tested with both short and continuous exposure. Particular interest was focused on the results obtained in the HCT8-FU cell line, a subline with experimentally induced resistance to 5-FU. The positive modulation of both cisplatin and epirubicin cytotoxicity by 5-FU makes the ECF regimen an attractive protocol for combination therapy in colorectal cancer.