重组人血管内皮抑素联合ＦＯＬＦＯＸ４方案治疗晚期大肠癌的临床观察

目的　评价重组人血管内皮抑素（恩度）联合ＦＯＬＦＯＸ４方案治疗晚期大肠癌的有效性和安全性。方法 经病理组织学检查确诊的晚期大肠癌患者１８例接受恩度联合ＦＯＬＦＯＸ４方案治疗。恩度１５ｍｇ加生理盐水５００ｍｌ静脉缓慢滴注，ｄ１ ～ｄ１４，间歇７天，重复给药；ＦＯＬＦＯＸ４方案具体为：奥沙利铂（Ｌ-ＯＨＰ）８５ｍｇ／ｍ２，静脉滴入２ｈ，ｄ１；亚叶酸钙（ＣＦ）２００ｍｇ／ｍ２，静脉滴入２ｈ，氟尿嘧啶（５-ＦＵ）４００ｍｇ／ｍ２静脉推注后予以６００ｍｇ／ｍ２持续静脉滴入２２ｈ，ｄ１～ｄ２。每２周重复，２８天为１周期；３～４周期后评价疗效。结果　１８例患者均如期完成治疗，可评价客观疗效和安全性。获ＰＲ１１例，ＳＤ３例，ＰＤ４例，客观有效率为６１.１％（１１／１８），疾病控制率为７７.８％（１４／１８）。主要毒副反应为骨髓抑制、消化道反应和周围神经毒性，无４级毒副反应，无心律失常及出血发生。结论　恩度联合ＦＯＬＦＯＸ４方案治疗晚期大肠癌具有协同作用，疗效好，毒性低，安全性好，值得临床进一步观察。

Efficacy of endostar and FOLFOX 4 in advanced colorectal carcinoma

Objective To evaluate the validity and drug safety of endostar and FOLFOX 4 regimen in advanced colorectal carcinoma. Methods Eighteen advanced colorectal carcinoma patients by pathological were observed. They were treated with endostar and FOLFOX 4 regimen, Endostar（ 15mg solved in 500ml of normal saline） was slowly dropped from day 1 to 14, repeating after a week. FOLFOX 4 regimen： oxaliplatin 85mg/m^2 iv infusion for 2 hours, d1 ;CF 200mg/m^2 iv infusion for 2 hours followed by 5-FU 400mg/m^2 iv bolus and 600mg/m^2 iv infusion for 22 hours, dl-d2. Every two weeks was repeated. 28 days was a cycle. Patients were evaluated after 3-4 cycles. Results Among 18 cases, there were 11 cases PR, 3 cases SD and 4 cases PD. The response rate was 61, 1% （11/18） and the disease control rate was 77.8% （14/18）. The main adverse effects were bone marrow suppression, gastrointestinal toxicity and neurotoxicity. There was no toxicity and adverse effect of grade 4 in these patients. Arrhythmia and hemorrhage did not occur. Conclusion Endostar and FOLFOX 4 regimen in advanced colorectal carcinoma have advantages including good therapeutic effects and less adverse reaction for the patients and it worth further study.