奥沙利铂联用氟脲嘧啶、亚叶酸钙治疗晚期大肠癌的临床研究

目的观察奥沙利铂联用氟脲嘧啶、亚叶酸钙治疗晚期大肠癌(ACRC)的疗效和安全性。方法收治晚期大肠癌患者30例，采用L-OHP130mg／m^2静脉滴注4hd1；CF200mg／m^2静脉滴注半小时后5-Fu500mg／m^2静脉滴注6hd1-5,每3周重复。结果部分缓解(PR)9例，稳定(SD)8例，进展(PD)8例，总有效率36％。毒性反应主要为感觉神经毒性(90％)，其次为恶心呕吐(60％)和腹泻(46．7％)。骨髓抑制毒性小。结论L-OHP联合5-Fu、CF治疗大肠癌疗效肯定，耐受性良好，值得临床进一步研究。     

奥沙利铂联合氟脲嘧啶及亚叶酸钙治疗晚期大肠癌的临床研究

目的 观察奥沙利铂（L—OHP）联合氟脲嘧啶（5-Fu）及亚叶酸钙（cF）治疗晚期大肠癌的疗效和不良反应。方法 42例晚期大肠癌患者，采用奥沙利铂120mg／m^2，静脉滴注4h，d1；亚叶酸钙200mg／m^2，静脉滴注2h，d1～5；氟脲嘧啶500mg／m^2，静脉滴注4h，dl～5；3周为1个周期。结果 42例患者中CR3例（7．1％），PR14例（33．3％），SD18例（42．9％），PD7例（16．7％），总有效率（CR＋PR）40．5％（17／42）。主要的不良反应为消化道症状，骨髓抑制和感觉神经毒性。结论 奥沙利铂联合氟脲嘧啶及亚叶酸钙治疗晚期大肠癌疗效肯定，不良反应轻，值得临床应用。     

奥沙利铂联用氟脲嘧啶、亚叶酸钙治疗晚期大肠癌的临床研究

目的　观察奥沙利铂联用氟脲嘧啶、亚叶酸钙治疗晚期大肠癌 (ACRC)的疗效和安全性。方法　收治晚期大肠癌患者 3 0例 ,采用L_OHP 13 0mg/m2 静脉滴注 4hd1 ;CF 2 0 0mg/m2 静脉滴注半小时后 5_Fu 5 0 0mg/m2 静脉滴注 6hd1～ 5,每 3周重复。结果　部分缓解 (PR) 9例 ,稳定 (SD) 8例 ,进展 (PD) 8例 ,总有效率 3 6%。毒性反应主要为感觉神经毒性 ( 90 %) ,其次为恶心呕吐 ( 60 %)和腹泻 ( 4 6 7%)。骨髓抑制毒性小。结论　L_OHP联合 5_Fu、CF治疗大肠癌疗效肯定 ,耐受性良好 ,值得临床进一步研究     

奥沙利铂联合氟脲嘧啶、亚叶酸钙治疗晚期胃癌临床观察

目的:观察奥沙利铂联合氟脲嘧啶、亚叶酸钙治疗晚期胃癌的疗效和安全性.方法:26例晚期胃癌,采用L-OHP 130mg/m2静滴4小时第1天;CF 200m/m2静滴2小时后5-Fu 500mg/m2静滴4小时第1～5天,每三周重复.结果:26例晚期胃癌中,CR 2例(7.7%),PR 11例(42.3%),CR+PR 50.0%.中位缓解期为5.5个月,中位生存期为11.0个月.毒性反应主要是感觉神经毒性(65.4%),其次为恶心呕吐(53.8%)和腹泻(46.2%).骨髓抑制毒性小.结论:L-OHP联合5-Fu、CF治疗晚期胃癌疗效肯定,耐受性良好,值得临床进一步应用.     

奥沙利铂联合氟脲嘧啶、亚叶酸钙治疗晚期胃癌临床观察

目的：观察奥沙利铂联合氟脲嘧啶、亚叶酸钙治疗晚期胃癌的疗效和安全性。方法：26例晚期胃癌，采用L-OHP130mg／m^2静滴4小时第1天；CF200mg／m^2静滴2小时后5-Fu500mg／m^2静滴4小时第1—5天，每三周重复。结果：26例晚期胃癌中，CR 2例(7．7％)，PR 11例(42．3％)，CR PR 50．0％。中位缓解期为5．5个月，中位生存期为11．0个月。毒性反应主要是感觉神经毒性(65．4％)，其次为恶心呕吐(53．8％)和腹泻(46．2％)。骨髓抑制毒性小。结论：L-OHP联合5-Fu、CF治疗晚期胃癌疗效肯定，耐受性良好，值得临床进一步应用。     

奥沙利铂联合5-氟脲嘧啶／亚叶酸钙治疗晚期胃癌临床研究

目的：研究奥沙利铂联合5-氟脲嘧啶／亚叶酸钙治疗进展期胃癌的临床疗效及毒副反应。方法：将66例晚期胃癌患者随机分成两组，研究组33例，奥沙利铂130mg／m^2，静滴3小时，第一天给药；亚叶酸钙100mg，静滴2小时。第1—5天给药；5-氟脲嘧啶600mg／m^2，微量泵持续静脉灌注22小时，第1—5天给药。对照组33例，顺铂30mg／m^2，静脉滴注，第1—3天给药，亚叶酸钙和5．氟脲嘧啶用药方法同研究组。每3—4周为一周期。结果：研究组与对照组近期有效率分别为54．5％与42．4％，两组比较无统计学差异（P〉0．05）；研究组1年生存率及中位生存期均优于对照组，但无统计学差异（P〉0．05）；消化道反应发生率研究组低于对照组（P〈0．05）．外周神经毒性反应发生率研究组高于对照组（P〈0．01）。结论：研究组近期疗效、1年生存率及中位生存期均优于对照组，且消化道反应发生率明显低于对照组，值得临床进一步观察研究。     

奥沙利铂联合5-氟脲嘧啶/亚叶酸钙治疗晚期胃癌临床研究

目的:研究奥沙利铂联合5-氟脲嘧啶/亚叶酸钙治疗进展期胃癌的临床疗效及毒副反应.方法:将66例晚期胃癌患者随机分成两组,研究组33例,奥沙利铂130rmg/m2,静滴3小时,第一天给药;亚叶酸钙100mg,静滴2小时,第1～5天给药;5-氟脲嘧啶600mg/m2,微量泵持续静脉灌注22小时,第1～5天给药.对照组33例,顺铂30mg/m2,静脉滴注,第1～3天给药,亚叶酸钙和5-氟脲嘧啶用药方法同研究组.每3～4周为一周期.结果:研究组与对照组近期有效率分别为54.5%与42.4%,两组比较无统计学差异(P＞0.05);研究组1年生存率及中位生存期均优于对照组,但无统计学差异(P＞0.05);消化道反应发生率研究组低于对照组(P＜0.05);外周神经毒性反应发生率研究组高于对照组(P＜0.01).结论:研究组近期疗效、1年生存率及中位生存期均优于对照组,且消化道反应发生率明显低于对照组,值得临床进一步观察研究.     

奥沙利铂联合亚叶酸钙与5-氟脲嘧啶治疗老年晚期结直肠癌的临床研究

目的评价国产奥沙利铂（L-OHP）联合亚叶酸钙（CF）、5-氟脲嘧啶（5-Fu）治疗局部晚期或转移性老年结直肠癌患者（≥70岁）的临床疗效及毒副反应。方法入组30例患者，方案L-OHP130mg／m^2静脉滴注2h，第1天；CF200mg／m^2静脉滴注2h，第1～5天；5一Fu425mg／m^2静脉滴注6h，第1-5天。每3周重复，两周期后评价疗效。结果30例患者均可评价疗效，无CR病例，PR15例，SD8例，PD7例，有效率为50％，中位生存期18个月，中位无进展生存9．5个月，1年生存率为66.7％。主要毒副反应为神经毒性，中性粒细胞减少，消化道反应及腹泻。结论L-OHP联合5-Fu／FA方案治疗局部晚期或转移性老年结直肠癌患者疗效较高，耐受性较好，值得进一步研究。     

多西紫杉醇联合奥沙利铂5-氟脲嘧啶和亚叶酸钙治疗晚期胃癌的临床研究

化疗是晚期胃癌的主要姑息治疗手段, 但临床疗效不令人满意。新的化疗药物如泰素帝、 伊立替康及奥沙利铂等疗效令人关注。     

奥沙利铂联合5-氟脲嘧啶及亚叶酸钙治疗老年晚期结直肠癌的临床研究

目的:评价国产奥沙利铂(L-OHP)联合5-氟脲嘧啶(5-Fu)、亚叶酸钙(CF)治疗局部晚期或转移性老年结直肠癌患者(≥70岁)的临床疗效及毒副反应。方法:入组30例患者,方案L-OHP 130mg/m2静脉滴注3小时,第1天;CF 200mg/m2静脉滴注2小时,第1天;5-Fu 400mg/m2静脉推注后续以2400mg/m2静脉泵入48小时,每3周重复,两周期后评价疗效。结果:30例患者均可评价疗效,CR 1病例,PR 12例,MR 8例,NC 6例,PD 3例,有效率43.3%,中位生存期11.8个月,中位无进展生存7.3个月,1年生存率为66.7%。主要毒副反应为神经毒性、骨髓抑制、消化道反应、粘膜炎和外周静脉炎。结论:L-OHP联合5-Fu/CF方案治疗局部晚期或转移性老年结直肠癌患者疗效较高,耐受性较好,值得推广应用。     

奥沙利铂联合5-氟尿嘧啶、亚叶酸钙治疗晚期消化道肿瘤的临床观察

目的观察奥沙利铂联合5-氟尿嘧啶、亚叶酸钙治疗晚期消化道肿瘤的临床疗效及不良反应。方法64例均有组织病理学诊断及可评价客观指标。采用奥沙利铂130mg/m2d1,亚叶酸钙(CF)200mg/m2+5-氟脲嘧啶300mg/m2d1~5化疗,3周为一周期,三周期评价疗效。结果64例均可评价疗效和不良反应。CR4例、PR33例、SD19例、PD8例。其中胃癌有效率为55.9%,结肠癌68.7%。直肠癌50.0%。主要的不良反应为骨髓抑制,消化道粘膜反应,感觉神经毒性但发生率较低。结论奥沙利铂联合5-氟脲嘧啶、亚叶酸钙治疗晚期消化道肿瘤有效率较高,不良反应可以耐受。     

L-OHP联合5-Fu和CF治疗晚期大肠癌的疗效观察

目的观察奥沙利铂联合5-氟脲嘧啶、甲酰四氢叶酸钙治疗晚期大肠癌的近期疗效。方法对43例晚期大肠癌采用奥沙利铂130mg／m^2静脉点滴2h，第1天；甲酰四氢叶酸钙200mg／m^2静脉点滴2h，第1～5天；5-氟脲嘧啶400mg／m^2静脉点滴8h以上，第1～5天。结果全组CR 1例，PR 20例，总有效率为48．8％(21／43)，中位无进展生存期为10．1个月，中位生存期为20．7个月；主要不良反应为骨髓抑制、神经毒性反应，Ⅲ度白细胞减少发生率为11．6％(5／43)，其它不良反应较轻。结论奥沙利铂联合5-氟脲嘧啶、甲酰四氢叶酸钙对晚期大肠癌有明显疗效，多数患者能耐受。     

Oxaliplatin and protracted continuous 5-fluorouracil infusion in patients with pretreated advanced colorectal carcinoma

Background:Both OHP and 5-FU are clinically active as single agents in the treatment of metastatic colorectal cancer (MCRC). Clinical and laboratory studies suggest a synergistic interaction between these agents. This phase II study was performed to evaluate the activity of a schedule including OHP and protracted 5-FU infusion in 5-FU-resistant MCRC. Patients and methods:From October 1997 to January 2000, 50 patients with measurable progressive MCRC after one or more 5-FU-based regimens were treated. OHP (2–3-hour i.v. infusion) on day 1 and 5-FU (protracted i.v. infusion using elastomeric/electronic pump through a central venous catheter) on days 1–21 were administered every 3 weeks, at the following 4 dose levels: 1) OHP 100 mg/m² + 5-FU 200 mg/m² (21 patients); 2) OHP 100 mg/m² + 5-FU 250 mg/m² (3 patients); 3) OHP 130 mg/m² + 5-FU 200 mg/m² (10 patients); 4) OHP 130 mg/m² + 5-FU 250 mg/m² (16 patients). Results:Objective responses were 1 (2%) CR; 10 (20%) PR, for a median duration of 8 months; 23 (46%) stable diseases, for a median duration of 6 months; 16 (32%) progressions. CR + PR was higher in patients who had previously received no more than one line of chemotherapy for metastatic disease as compared with patients who had received two or more lines of therapy (33% vs. 5%, P < 0.01). The median time to progression was four months (one to nine). All dose levels (313 cycles) were well tolerated with mild toxicity. Major toxicity (grade 3 WHO) included: anaemia in 1 patient (2%), nausea and vomiting in 1 patient (2%), diarrhoea in 4 patients (8%) and stomatitis in 1 patient (2%); grade 1 and 2 peripheral neuropathy were encountered, respectively, in 30 (60%) and 8 (16%) patients. The median survival was 13 months (9–17), with 32 patients still alive after a median follow-up of 8 months. Conclusions:This study suggests that 1) OHP plus protracted 5-FU infusion is an active combination in MCRC patients resistant to pre-treatment bolus 5-FU; 2) it has a good tolerability profile and 3) the optimum dose level is OHP 130 mg/m² and 5-FU 250 mg/m².     

Clinical Study of Combining Chemotherapy of Oxaliplatin or 5-Fluorouracil/Leucovorin with Hydroxycamptothecine for Advanced Colorectal Cancer

OBJECTIVE To estimate the short-time efficacy, side effects, survival rate after the treatment of combining chemotherapy of oxaliplatin or 5-fluorouracil/leucovorin with hydroxycamptothecine (HCPT) for the patients with advanced colorectal cancer.METHODS From January 2002 to November 2005, 59 patients with advanced colorectal cancer confirmed by pathology were enrolled into this study in the department of medical oncology,in the Sixth People's Hospital of Shanghai Jiaotong University,Shanghai. Patients' characteristics in two groups were similarly confirmed by statistic. All 37 patients in OH group received oxaliplatin (130 mg/m2 dl) plus hydroxycamptothecine (6mg/m2 d1-4), and all 22 patients in the HLF group received hydroxycamptothecine (6 mg/m2 d1-4) plus leucovorin (300 mg d1-5) and 5-fluorouracil (0.375 g/m2 d1-5). The regimens in both groups were 21-day cycle that was repeated three weeks. The side effects were evaluated. The efficacy was estimated after two cycles of chemotherapy for each patient.RESULTS The efficacy of the treatment in the OH group with 37 patients and in the HLF group with 22 patients was estimated.The overall response rate (CR + PR) was 32.4% in the OH group and 22.7% in the HLF group. There was no complete response (CR) and there was no statistical significantly difference (x2= 0.876,P = 0.704) in two groups. The 1-year survival rate was 30.98%in the OH group and 15.02% in the HLF group, and it had no significant difference between the two groups. The median PSF and OS were 5.83 months and 11.17 months in the OH group vs.7.40 months and 10.48 months in the HLF group, and it had no significant differences between the two groups (P > 0.05). The major side effects of grade Ⅲ and Ⅳ in the two groups were myelosuppression and gastrointestinal reactions. The statistically significant difference in side effects appeared in leukoperda (x2=17.173, P = 0.001), nausea/vomiting (x2 = 6.426, P = 0.039), diarrhea (x2 = 16.245, P = 0.000) and peripheral neuropathy.CONCLUSION The efficacy was almost equal between the OH and the HLF groups, and the two regimens can be used as the second-line treatments for the patients with colorectal cancer. Leucopenia, nausea, diarrhea and peripheral neuropathy appeared more in OH group, and anemia and thrombocytopenia were almost equal between the OH and the HLF groups.     

羟基喜树碱联用氟脲嘧啶／醛氢叶酸治疗晚期大肠癌的临床研究

目的：观察羟基喜树碱（hydroxycamptothecin,HCPT）与醛氢叶酸（leucovorin,LV）、氟脲嘧啶（fluorouracil,5-FU)组成的HLF方案对晚期大肠癌的疗效及不良反应。方法：治疗组27例予HLF方案化疗,HCPT6-8mg/m^2,第1-5天静滴;LV20mg/m^2,第1-5天静注：5-FU425mg/m^2,第1-5天静注。对照组35例予Mayo方案化疗,LV及5-FU用法同治疗组。以上方案每4周重复。结果：HLF方案和Mayo方案有效率、疾病进展时间（time to progression,TTP）分别为29.6%vs22.9%（P=0.546）和29.0周vs22.0周（P=0.0238）。主要不良反应为消化系统、血液系统毒性,多为Ⅰ-Ⅱ度,患者耐受良好。结论：HLF方案治疗晚期大肠癌,可能有助于提高有效率、延缓疾病进展,值得临床进一步观察研究。     

国产奥沙利铂联合亚叶酸钙和5-氟脲嘧啶治疗晚期结直肠癌的临床观察

目的：评价奥沙利铂联合亚叶酸钙、5—氟脲嘧啶(OXA—CF—5—Fu)方案治疗晚期结直肠癌的疗效与安全性。方法：奥沙利铂(OXA)130mg／m^2,静脉滴注4h,d1;亚叶酸钙(CF)200mg静脉滴注2小时,5—氟脲嘧啶(5—Fu)0．25g于CF滴完后静脉推注,5-Fu0．5g持续静脉滴注6-8小时,d1-5,每3周重复。结果：全组26例患者,有效率(CR PR)为42．31％,不良反应为恶心、呕吐和骨髓抑制,但多为Ⅰ～Ⅱ度,一过性感觉异常。结论：奥沙利铂联合亚叶酸钙和5—氟脲嘧啶治疗晚期结直肠癌疗效较高,不良反应轻而且安全。     

低剂量5-氟尿嘧啶持续静注联合顺铂治疗晚期胃癌的临床研究

目的 :评价低剂量 5 氟尿嘧啶 (5 FU)持续滴注联合顺铂 (DDP)治疗晚期胃癌的疗效及其毒副作用。方法 :4 3例晚期胃癌 ,应用 5 FU 2 5 0mg m2 ·d ,经静脉微量泵持续 2 4小时注射 (civ) ,DDP 6mg m2 ·d ,1小时 ,每周 5天 ,均连用 3周 ;间隔1周后重复。化疗 2周期为 1疗程 ,按WHO标准评价疗效和毒性。结果 :4 3例中有 32例可以进行评价 ,其中CR 2例 (6 3% ) ,PR 11例 (34 4 % ) ,NC 7例 (2 1 9% )和PD 12例 (37 5 % ) ,总有效率 4 0 7% ;毒副反应主要为消化道反应 ,骨髓抑制较轻。结论 :低剂量 5 FU持续静注加顺铂方案是一个有效而低毒的方案 ,适用于晚期胃癌患者     

紫杉醇联合小剂量顺铂和持续静滴低剂量氟尿嘧啶治疗晚期胃癌35例

目的观察紫杉醇(PTX)联合小剂量顺铂(PDD)和持续静滴低剂量氟尿嘧啶(5-FU)治疗晚期胃癌的疗效和毒副反应。方法全组35例患者中,贲门癌14例,胃体癌21例,应用PTX90mg/m2,第1、8天;5-FU250mg/m2持续24小时静滴,连用12天;PDD6mg/(m2.d)静滴,连用5天,间隔2天,再用5天,21天为1周期,平均用药3.06个周期。结果全组35例均可评价,获得CR3例,PR17例,SD10例,PD5例,有效率(CR PR)为57.1%,肿瘤控制率(CR PR SD)为85.7%,中位TTP为9个月(1~32个月),中位生存时间13个月(2~35个月)。主要不良反应为骨髓抑制、恶心呕吐和粘膜炎。结论紫杉醇联合小剂量顺铂和持续静滴低剂量氟尿嘧啶治疗晚期胃癌患者疗效较好,不良反应可以耐受,值得深入研究。     

奥沙利铂联合5-氟尿嘧啶、亚叶酸钙治疗晚期胃癌的临床疗效观察

目的探讨奥沙利铂(OXA)联合氟尿嘧啶(5-Fu)和亚叶酸钙(CF)静脉滴注治疗晚期胃癌的临床疗效和不良反应。方法治疗组36例晚期胃癌患者,第1天奥沙利铂85mg/m2,静脉滴注2h静脉滴注,亚叶酸钙(CF)400mg/m2,静脉滴注2h后,氟尿嘧啶(5-Fu)400mg/m2,静脉推注15min;再用氟尿嘧啶(5-Fu)2400mg/m2,持续静脉滴注泵连续滴注46h。每2周重复1次,化疗3个周期后评价疗效;对照组32例晚期胃癌患者,亚叶酸钙(CF)100mg/m2,静脉滴注2h,d1-5,氟尿嘧啶(5-Fu)500mg/m2,静脉滴注6h,d1-5,顺铂(DDP)20mg/m2,静脉滴注2h,d1-5,每3周重复1次,化疗2个周期后评价疗效。结果治疗组完全缓解1例,部分缓解16例,有效率为47.2%,中位疾病进展时间为5.5个月,中位生存期为10.8个月,不良反应主要为感觉神经毒性。对照组部分缓解13例,有效率为40.6%,中位疾病进展时间为4.0个月,中位生存期为8.8个月,不良反应主要为恶心呕吐。结论奥沙利铂联合氟尿嘧啶和亚叶酸钙治疗晚期胃癌近期疗效较好,不良反应轻。     

Treatment of Advanced Gastric Carcinoma Patients with Calcium Folinate, a 5-Fluorouracil Bolus and Continous Infusion with 5-Infusion with 5-Fluorouracil Combined with Oxaliplatin

OBJECTIVE To examine the therapeutic effects and toxicity of high-dose-folinic acid plus a 5-fluorouracil (5-FU) bolus and continuous infusion with 5-FU combined with locally produced oxaliplatin (L-HOP)in treating advanced gastric carcinoma patients.METHODS Sixty-five patients with advanced gastric carcinoma were treated with high-dose-folinic acid plus a 5-FU bolus and a 48-h continuous infusion of 5-FU combined with oxaliplatin. The effects of treatment and toxicity were observed.RESULTS There were 4 complete responses, 26 partial responses,30 with no change and 5 with progressive disease. The overall effective response rate was 46.2% (30/65). The median duration was 7 months, with the main side effects including nausea and vomiting, peripheral phlebitis, alopecia, leukopenia, dental ulcers,peripheral neuritis and diarrhea. All the side effects were tolerated and minimal.CONCLUSION The results showed that high-dose folinic acid plus a 5-FU bolus and continuous infusion of 5-FU combined with oxaliplatin appears to be a safe and effective therapy for patients with advanced gastric carcinoma. This therapeutic regimen is of value for these patients.