奥沙利铂联合氟尿嘧啶、四氢叶酸辅助治疗局部晚期胃癌

目的 探讨胃癌术后奥沙利铂联合氟尿嘧啶(5-Fu)、四氢叶酸方案(FOLFOX方案)辅助化疗的疗效及安全性.方法 回顾性分析2002年11月至2007年5月中国医学科学院中国协和医科大学北京协和医院肿瘤内科收治的使用FOLFOX方案辅助化疗的所有胃癌患者.共25例,其中Ⅱ期2例,Ⅲ期17例,Ⅳ期6例.化疗方案:奥沙利铂(L-OHP)85 mg/m2,静脉滴注2 h,第1天;四氢叶酸200 mg/m2,静脉滴注2 h,第1～2天;5-FU 400 mg/m2,静脉注射,第1～2天,5-Fu 600 mg/m2,持续静脉滴注22 h,第1～2天;每2周重复.结果 中位无病生存时间(DFS)26.0个月,中位总生存时间38.0个月;1年生存率91.3%,2年生存率63.9%.3或4度不良反应发生率较低,主要是中性粒细胞减少(12.4%)和血小板减少(8.2%),恶心(7.5%).结论 FOLFOX方案不良反应轻,耐受好;在胃癌的辅助治疗中表现了令人期待的疗效,值得进一步验证.

Post-operative adjuvant treatment with oxaliplatin, fluorouracil, and leucovorin for local advanced gastric cancer

OBJECTIVE: To evaluate the toxicity and efficacy of combination regimen with oxaliplatin plus fluorouracil and leucovorin(FOLFOX) as post-operative adjuvant chemotherapy in local advanced gastric cancer. METHODS: Twenty-five gastric cancer patients, 2 at the stage II, 17 at the stage III, and 6 at the stage IV received the FOLFOX regimen after surgery: intravenous infusion of oxaliplatin 85 mg/m2 for 2 h on day 1, intravenous infusion of leucovorin 200 mg/m2 for 2 h on days 1-2, and intravenous bolus injection of 5-fluorouracil (5-FU) 400 mg/m2 on days 1-2, and continuous infusion of 5-FU 600 mg/m2 for 22 h on days 1-2; and this regimen was repeated every 2 weeks. The effect and adverse reactions were recorded. RESULTS: The median disease free survival time and overall survival time were 26.0 months and 38.0 months respectively. The frequent grade 3/4 toxicity of the FOLFOX regimen included: neutropenia (12.4%), thrombocytopenia (8.2%), and nausea (7.5%). CONCLUSION: The post-operative adjuvant chemotherapy of FOLFOX regimen has expectable efficacy in treatment of gastric cancer with light and well tolerable toxicity.