EAP／LF交替方案治疗进展期胃癌的临床研究

目的：探讨EAP／LF交替方案进展胃癌的疗效。方法：自1994年10月至1999年12月，124例经病理确诊的有可测量病灶的进展期胃癌患者被随机分入EAP／LF组（研究组）和EAP组（对照组），研究组用药为：足叶乙甙（Vp-16)70mg/m^2，静滴，d4-6；阿霉素（ADM）15mg/m^2，静注d1.7；顺铂（DDP）20mg/m^2，静滴，d2．8，醛氢叶酸（CF）70mg/m^2，静滴，d29－33，5－氟尿嘧啶（5－FU）325mg/m^2，静滴，d29－33，每8周重复，。结果：研究组客观有效率为62．1％，明显优于对照组的48．3％（P＝0．032）；研究组有效者中位生存期、无进展生存时间分别为20个月、13个月，均明显优于对照组13个月（P＝0．037）、7个月（P＝0．007）。两组不良反应主要有白细胞减少、口腔粘膜炎、脱发、结论：调整剂量的EAP／LF交替方案是一疗效确切，安全、对生存有益处的治疗进展期胃癌的优势方案，值得临床进一步研究。

Clinical Observation of Etoposide, Adriamycin, Cisplatin and Leucovorin, 5-Fluorouracil Alternating Regimen for Patients with Advanced Gastric Cancer

Objective: The aim of this study was to search new chemotherapy regimen to improve treatment for the patients with advanced gastric cancer. Methods: One hundred and twenty four evaluable patients from October 1994 to December 1999 with advanced measurable gastric carcinoma were involved in this study.They were randomly assigned into two groups: Sixty six cases in study group received Etoposide, Adriamycin, Cisplatin and Leucovorin, 5 Fluorouracil (EAP/LF) alternating regimen: Etoposide 70mg/m2,iv.on d4,5,6;Adriamycin 15 mg/m2,iv.on d1,7; Cisplatin 20 mg/m2, iv.on d2,8; Leucovorin 70 mg/m2, iv.on d29-33; and 5 Fluorouracil 325 mg/m2, iv.on d29-33, repeated every 8 weeks. Fifty eight cases in control group received Etoposide, Adriamycin, Cisplatin (EAP) regimen: Etoposide 70 mg/m2, iv.on d4,5,6,25,26,27; Adriamycin 15 mg/m2, iv.on d1,7,22,28; Cisplatin 30 mg/m2,iv.on d2,8,23,29;repeated every 8 weeks. Results: The response was 62.1% in testing group and 48.3% in control group (P=0.032). The median survival time and time to tumor progression were 20 months, and 13 months in testing group, and 13 months and 7 months in control group,respectively (P=0.037; P=0.007). The side effects were leucocytopenia,oral mucositis, and alopecia. Conclusion: The result of this investigation revealed that the EAP/LF alternating regimen is effective and secure. It prolongs the survival time of patients with advanced gastric cancer.